One of the greatest challenges facing the clinician is the treatment of a nonvital immature permanent tooth with an open apex. Treatment is considered a failure when preexisting radiolucent defects have grown in size or new defects appeared. Therefore, an intra-radicu-lar filling material should be non-toxic and easily resorbable. 125, CH-8053 Zurich, Switzerland) may be preferable. The morphology of the root canals in primary teeth makes endodontic treatment difficult and often impractical. Pulpotomy using formocresol and electrosurgery has also been described (Shulman et al., 1987). CLINICAL IMPLICATIONS: Vitapex is an excellent filling material for primary tooth pulpectomies. Hibbard and Ireland studied the primary root canal morphology by removing the pulp from extracted teeth, forcing acrylic resin into the pulp canals, and dissolving the covering of tooth structure in 10% nitric acid.19 It was apparent that, initially, only one root canal was present in each of the mandibular and maxillary molar roots. Pulpotomies refer to the opening of the root canal and the partial removal of the pulpal tissue. Although zinc oxide–eugenol paste is viewed as the traditional root canal filling material for primary teeth, multiple studies18–23 suggest that KRI paste (Pharmachemie AG, Drusberstr. pulpectomy in primary teeth: a 18-months clinical randomized controlled trial Xiaoxian Chen1, Xinggang Liu2* and Jie Zhong1 Abstract Background: To avoid untoward changes when primary teeth are replaced by permanent teeth, resorption of the material used in primary teeth root canal filling should occur at the same rate as root resorption. An ideal pulpotomy dressing material should be biocompatible, capable of hard tissue formation, have disinfectant properties and lack of cytotoxity. Pulpotomy is one of the clinical indications for use of lasers.29,57,58 Successful treatment can delay the need to extract a nonvital primary tooth until a space maintainer can be inserted. Advantages: The tooth is maintained in service. It is also "spun-down" into the canals using a lentulo spiral * running counter-clockwise on a slow speed handpiece. From the clinical aspect the endodontic treatment is divided into two groups: (1) teeth with pulp vitality (biopulpectomy) and (2) pulpless teeth (necropulpectomy). The tooth is then filled with material that can be reabsorbed by the body. In addition, the rubber dam helps prevent the swallowing or aspiration of foreign objects during treatment. The risk-benefit ratio for the patient favors pulpal extirpation. The primary components of Vitapex are calcium hydroxide and iodoform. Cautious manipulation is important, however, to prevent breaking the file or overinstrumentation of the canal and apical tissues. Nedley MP. Dean, in McDonald and Avery Dentistry for the Child and Adolescent (Ninth Edition), 2011. The use of micro-computed tomography has produced some exquisite views of the anatomy of primary molars (Figs. In the absence of rapidly progressing (inflammatory) root resorption, treatment is to obturate the canal with gutta-percha. Figure 35.8. The subsequent deposition of secondary dentin throughout the life of the teeth caused a change in the morphologic pattern of the root canal, producing variations and eventual alterations in the numbers and sizes of the canals. Root canal pluggers may be used to condense the filling material into the canals. The treatment should permit resorption of the roots of the primary tooth and filling material and allow normal eruption of the succedaneous tooth. It can usually be used even during the pulp extirpation procedure, while several teeth are splinted together. [30] 13-16). About The … These findings explain the complications often encountered in root canal therapy. Materials are inserted with a spiral lentulo mounted on a slow-speed engine, Insertion of paste with a plastic syringe, The ideal root canal filling material should resorb at the same pace as the physiologic resorption of the roots, be nontoxic to the periapical tissues and to the permanent tooth germ, resorbs readily if forced beyond the apex and be antiseptic, easy to insert, nonshrinkable, and easily removed if necessary [, A number of root canal filling materials can be used for primary teeth, with no known ideal root canal filling material. Those that do respond favorably may still require root canal treatment several months later. Diagram illustrates the level at which the canine tooth should be cut in relation to adjacent teeth. Khayat et al. They may be opened for drainage and often remain asymptomatic for an indefinite period. (1979) is excellent. 14.30). Lawrence Kotlow DDS, in Principles and Practice of Laser Dentistry, 2011, Primary teeth that have exposed pulp tissue resulting from caries, mechanical removal of carious tissue, or preventive procedures on severely abraded teeth require a pulpotomy or pulpectomy.52,53 In a pulpotomy, as defined by the American Academy of Pediatric Dentistry, the coronal pulp is amputated and the remaining vital radicular pulp tissue surface is treated with a medicament (e.g., formocresol, ferric sulfate)54 or with electrocautery to preserve the pulp's health. The materials used for obturation in this study included zinc oxide propolis (ZOP) as a new paste, Endoflas, Metapex, and zinc oxide eugenol (ZOE). A thick mix of the treatment paste should then be prepared, rolled into a point, and carried into the canal. (. Andreasen suggested that 2 weeks after replantation is the ideal time to fill the canal with calcium hydroxide. 30 or 35. Vitapex (New Dental Chemical Products Co. Ltd., Tokyo, Japan)/ Diapex: 30 % calcium hydroxide, 40.4 % iodoform, and 22.4 % silicone oil. — Pulpectomy for primary teeth can be carried out in a single visit, if the patient is not complaining of acute symptoms or there is no pus discharge from the canals . Root canal treatment should be initiated 7 to 10 days after replantation. ZINC OXIDE EUGENOL PASTE • It is the most commonly used root canal filling material for primary teeth. Folks, let's get terms straight here. An x-ray film may be necessary to allow the success in filling the canals to be evaluated (Fig. David T. Brown, Mathew T. Kattadiyil, in McDonald and Avery's Dentistry for the Child and Adolescent (Tenth Edition), 2016. In this technique, the gum flap is repositioned over the remaining tooth, with retention of nerve function and minimization of subsequent problems such as tooth root abscesses and devitalization of the tooth. Another popular root canal filling material for primary teeth is Vitapex (Dia Dent Group International, Inc., Vancouver, British Columbia, Canada), a product that has received many favorable anecdotal reports about its successful use in infected primary teeth. Mechanical removal of remnants from the canal is performed using a series of 21 mm long K-type endodontic files (Unitek Corp., Monrovia, CA) up to file No. James E. Jones, ... Ghaeth H. Yassen, in McDonald and Avery's Dentistry for the Child and Adolescent (Tenth Edition), 2016. From: Principles and Practice of Laser Dentistry (Second Edition), 2016, Dennis J. McTigue, ... Janice G. Jackson, in Pediatric Dentistry (Sixth Edition), 2019. If bleeding does occur, the canal must be explored, so that all pulpal tissue is removed. RCT in primary teeth may be completed in one visit. The file removes tissue only as it is withdrawn and penetrates readily with a minimum of resistance. Excess alloy is removed, and the tooth is sculptured smooth (Tomson et al., 1979) (Fig. Multiple visits over a period of 9 to 18 months were required, however, and the outcome was a shortened root with thin walls (Fig. preferred root canal filling material. Khairwa et al. Alternatively a Lentulo spiral file can be placed on an endodontic handpiece to spiral the filling material into the canals. Jeffrey A. In addition, there should be no radiographic evidence of a thickened periodontal ligament or of radicular disease. Instead of separate holes in the rubber dam for each tooth, a slit is made so that the rubber can be placed over all teeth in the splinted segment. It is the technique to gain an access to the root canals, remove as much dead & infected material as possible & fill the root canals with a suitable material to maintain the tooth in a non – infected state. Lasers provide a safe, effective, nonchemical alternative for pulpotomies.59,60 With more than 6 years of results on more than 5000 laser pulpotomies showing excellent results, the author can confirm the safety and effectiveness of this technique on children without using chemicals or electrosurgery (Figure 12-25). If the canal cannot be properly cleansed of necrotic material, sterilized, and adequately filled, endodontic therapy is more likely to fail. found that root resorption of primary molars is accelerated following pulpectomy with iodoform filling material in comparison with teeth without endodontic treatment . The presence of zinc oxide slows it resorption, and it was reported to have significantly higher success rates (100 %) compared to ZOE alone [, KRI paste (Pharmachemie, Zurich) is a mixture of iodoform (80.8 %), camphor, parachlorophenol, and menthol [, Dental operating microscopes, electronic apex locators, rotary nickel-titanium files and irrigation techniques are at the front of endodontic armamentarium today [, When considering the use of electronic apex locators, only few studies exist and most of them are either in vitro [, As for rotary instrumentation techniques in primary molars, in vitro studies found equal cleaning capacity but reduction of instrumentation time by the rotary technique [, Er,Cr:YSGG laser provided similar cleanliness as rotary instrumentation technique and was superior to manual instrumentation. The primary components of KRI paste are zinc oxide and iodoform. By continuing you agree to the use of cookies. Similarly, longer-than-normal retention of a second primary molar may be desired when the succedaneous second premolar is congenitally missing (Fig. The tooth should be restored with full coverage. Moreover, adverse reactions are virtually certain if degenerating pulp tissue is allowed to remain in the canals for more than a few days. S. en C.S. Six clinical trials selected for inclusion were independently reviewed by two researchers. 6. from Columbia South America): tri-iodmethane and iodine dibutilorthocresol (40.6 %), zinc oxide (56.5 %), calcium hydroxide (1.07 %), and barium sulfate (1.63 %) with a liquid consisting of eugenol and paramonochlorophenol, Without setting accelerators may be pushed into the root canals using a suitable root canal plugger, Introduced into the root canal using disposable tips or a spiral lentulo mounted on a slow-speed handpiece, Introduced into the root canal using a spiral lentulo. ZOE tends to resorb at a slower rate than the roots of the primary teeth [, ZOE extruded beyond the apices set into a hard cement that resists resorption (, The antimicrobial action of calcium hydroxide is associated with its ionic dissociation. (FIG. After the pulp tissue has been removed from the canals, a syringe is used to irrigate them with 3% hydrogen peroxide followed by sodium hypochlorite. Materials used in pulpotomy dressing usually affect the success rate of pulpotomy. A sterile, dry cotton pellet or one dampened with CMCP and blotted on sterile gauze may be sealed in the pulp chamber after debridement and irrigation. However, they are a source of infection and should be treated or removed. The root canals are irrigated with either 0.2 % up to 2 % chlorhexidine solution or with 1 % up to 5 % sodium hypochlorite (limited to one percent sodium hypochlorite according to the AAPD guidelines) (Fig. • Advantages - it has bactericidal effect. Further condensation may be carried out if required. Pulpectomy : Definition, Indication and Contra-indication. These procedures have been used in veterinary medicine for treating tooth fractures and pulp infections and for disarming dangerous animals. In root canal treatment, the dentist will first perform the pulpectomy procedure in which the entire root canal system is cleaned, shaped, filled, and sealed. 35.8). A thick mix of ZOE (Zinc Oxide BP, Eugenol BP, Associated Dental Products Ltd, Purton, England) without setting accelerators may be pushed into the root canals using a suitable root canal plugger. Many dentists prefer to use root canal instruments placed in a special handpiece for root canal débridement. showed that all root canals obturated with gutta-percha and root canal sealer using either lateral or vertical condensation were recontaminated in less than 30 days when exposed to saliva. If any of these conditions is present, a complete pulpectomy (described later) or an extraction should be performed. If the avulsed permanent tooth has immature root formation with an open apex, the chances of pulpal revitalization after replantation improve considerably, especially if replantation occurs within 30 minutes after avulsion. Leonardo MR, Leal JM, Simões Filho AP. VARIOUS ROOT CANAL OBTURATING MATERIALS FOR PRIMARY TEETH Most commonly used materials for primary root canal fillings are Iodoform based pastes Walcoff paste KRI paste Maisto paste Vitapex/metapex Endoflas Zinc oxide … 19-14). If the supporting bone is also compromised, the likelihood of successful endodontic therapy is lower. Vitapex may be at least as effective as KRI paste, and Nurko and García-Godoy26,29 have published some reports of studies in humans. Further condensation may be carried out if required. BACKGROUND: The pulpectomy is an underutilized treatment modality for severely infected primary teeth. Aminabadi and colleagues have demonstrated that while primary second molars are more accessible than first molars, all of them are negotiable.20 In addition, other studies have investigated ultrasonic instrumentation21 and root apex locators22 in the root canal treatment of primary teeth. 2001;19:107-109. Filling the treated tooth with reabsorbable material As compared to the pulpectomy procedure, a root canal treatment generally requires more than one visit to the dentist. Though overall treatment time is greatly reduced, the shortened root and thin walls continue to place the tooth at risk for subsequent cervical root fracture. The pulp should be extirpated before the splint is removed, however, and preferably within 1 week after the injury. Early extirpation of the pulp may help to control the early onset of inflammatory root resorption.54 Filling the root canal with calcium hydroxide also controls and may even arrest external inflammatory root resorption. Because posts and cores do not strengthen endodontically treated teeth, their use is indicated only when the remaining coronal tooth structure does not provide adequate retention for definitive restoration. Even though trauma may result in restoration dislodgement or perhaps even fracture of the tooth, the tooth will have survived at least one more traumatic experience. (A) Preoperative view. Conclusions: The mixture of ZOE, iodoform and calcium hydroxide can be considered an effective root canal filling material in pulp involved primary teeth and had no adverse effect on tooth replacement. Rubber dams are used on all teeth to prevent contamination of the root canal with microorganisms from the oral cavity. Roots of the primary teeth will begin to resorb as soon as the root length is completed. A temporary filling material is applied between the visits. This resorption causes the position of the apical foramen to change continually [. The radiograph performed before root canal treatment (in this case, of the lower right second primary molar) should demonstrate the pulp chamber and the full length of the canals, The success of endodontic treatment depends on elimination of the infecting bacteria accomplished through adequate root canal debridement (instrumentation), antibacterial irrigations, and antibacterial filling materials [, Root canal treatment in primary teeth is indicated when the radicular pulp exhibits clinical signs of irreversible pulpitis or pulp necrosis, while the roots show minimal or no resorption. Zinc oxide eugenol or zinc oxide eugenol/iodoform combined with Ca(OH) 2 appears to be the materials of choice if primary teeth are not nearing exfoliation. It is challenging to select the appropriate filling materials for primary teeth. Design: Fifty prototypes were instrumented and randomly divided (n = 10) according to the filling materials (Vitapex ® , ZOE, Calcicur ® , Feapex, and Calen ® -ZO) and obturation technique: lentulo or pressure syringe (n = 5). If the calcium hydroxide is placed in the canal too soon (before adequate healing of the periodontal ligament), however, it may stimulate replacement root resorption. The aim of this systematic review was to determine whether there is a root canal filling for deciduous teeth equally or more effective than zinc oxide-eugenol cement (ZOE). Concept and procedures. Paper points are used to dry the canal and check for the presence of blood (Tomson et al., 1979). Considerable laboratory and animal research has been reported. It is particularly important that the teeth in the mouths of accident-prone adolescents or in whom athletic trauma has previously occurred be restored without a post, if possible. Fig. Zinc oxide eugenol and aloe vera. The excess thin paste may be removed with paperpoints and Hedström files. The root canals are first irrigated with either 0.2 % up to 2 % chlorhexidine solution or with 1 % up to 5 % sodium hypochlorite and then with normal saline, The use of sodium hypochlorite in the primary dentition should be performed cautiously since it is a potent tissue irritant and must not be extruded beyond the apex [, Sodium hypochlorite accident in a pediatric patient. Ralph E. McDonald, ... Jeffrey A. Excellent results have been observed in many cases. 6). The canals are completely filled with ZOE. Endodontic procedures for the treatment of primary teeth are indicated if the canals are accessible and if there is evidence of essentially normal supporting bone. Radiographic lesions present preoperatively should resolve within 6 months, as evidenced by bone deposition and a decrease or disappearance or at least no change in pretreatment radiolucent areas. An apexification procedure allowed this immature permanent tooth to be obturated successfully with gutta-percha (GP). During the time beyond 1 week that the pulp tissue is allowed to remain, evaluation of the tooth is recommended at weekly intervals until favorable signs of healing without pulpal pathosis are conclusive (vitality tests are unreliable) or until a decision is made to extirpate the pulp. The success rate with calcium hydroxide varied between 86.7 and 100% [10, 11]. The success of pulpectomy in primary teeth depends on selecting the ideal root canal filling material. Some have advocated a more permanent technique involving the placement of a permanent pulp cap (Reynolds and Hall, 1979). When the canal is filled, calcium hydroxide paste is the material of choice. It’s usually performed on baby teeth. Pulpectomy should not be confused with pulpotomy, ... the root canal and the pulp chamber are filled with an inert and non-absorbable material. The resulting space is then filled with special, medicated, dental materials, which while fill not allowing further maturation restore the tooth to its normal function. In cases in which an adjacent tooth is still unerupted, calcium hydroxide treatment is recommended until eruption of the adjacent tooth.55 It is believed that eruption may stimulate or accelerate the resorptive process in a nearby replanted root. (C) Twenty-seven-month postoperative view. If small endodontic instruments are used without rubber dam protection, they should be secured with a length of dental floss to facilitate retrieval in the unlikely event that they are dropped in the patient’s mouth. ... Parirokh M. Sealing ability of a novel endodontic cement as a root-end filling material. The minimally invasive endodontic techniques of vital pulp therapy (VPT) are based on improved understanding of the capacity of pulp (nerve) tissues to heal and regenerate plus the availability of advanced endodontic materials. Pulpectomy is a dental procedure where the whole dental pulp is removed, both the coronal and radicular part. Small Kerr files may be used to file the paste into the walls. Currently, pulpectomies in primary teeth are commonly completed in a single appointment. When hemorrhage is controlled and the canals remain dry, a thin mix of filling paste may be prepared. Result of Nontreatment: Usually the patient will experience continued and increased pain and infection, and removal of the tooth will be required. Pulpotomy is a minimally invasive procedure performed in children on a primary tooth with extensive caries but without evidence of root pathology. A post obturation radiograph is … Broaches are used to remove all pulpal tissue from the root canal. Mature first primary molar canals are often so small that they are inaccessible even to the smallest barbed broach. Root canal instrumentation may be facilitated with the judicious use of this mechanical technique, especially in canals that are difficult to negotiate with hand instruments. Success rate of root canal treatments in primary teeth has been discussed in the literature. Dean, in, McDonald and Avery Dentistry for the Child and Adolescent (Ninth Edition), A Consumer's Guide to Dentistry (Second Edition), Laboratory Animal Medicine (Second Edition), More recently, the surgical techniques of, Management of Trauma to the Teeth and Supporting Tissues, Prosthodontic Treatment of the Adolescent Patient, Principles and Practice of Laser Dentistry, Primary teeth that have exposed pulp tissue resulting from caries, mechanical removal of carious tissue, or preventive procedures on severely abraded teeth require a pulpotomy or, The Journal of the American Dental Association, American Journal of Orthodontics and Dentofacial Orthopedics. Objective To evaluate the success rate of pulpectomy of primary molars using four different root canal filling materials: ZOP as a new paste, Endoflas, Metapex, and ZOE. The pulpectomy completed by obturating with a cream past of ZOE introduced into the canal first using a file. Drying the canals should be performed with appropriately sized sterile paper points. In the case of pulpal involvement when the root is incompletely formed, a pulpotomy followed by placement of an appropriate restoration is indicated. Pulpectomy in deciduous teeth is a common procedure in dental practice, seeking to preserve function of the pulpally involved tooth. The root canal is then irrigated with sterile saline. Pulpectomy and endodontic therapy are not common procedures in pediatric dentistry because of their occasional failure versus the success of pulpotomy procedures. Another popular root canal filling material for primary teeth is Vitapex (Dia Dent Group International, Inc., Vancouver, British Columbia, Canada), a product that has received many favorable reports about its successful use in infected primary teeth. A Hedström file will be helpful in the removal of remnants of the pulp tissue. A pulpectomy involves complete pulp tissue removal from the crown and root and is indicated when no vital tissue remains. However, Trope suggests that the pulp contents be removed at the emergency visit and a tetracycline-corticosteroid combination (Ledermix; Sigma Pharmaceuticals Pty Lid., Croydon, Victoria, Australia) be placed in the root canal.48 He believes that this combination decreases the inflammatory response after replantation to allow for more favorable healing than in those teeth that do not receive the medicament. Increased sensitivity may result from pulpotomy because of the potential reaction of the remaining pulpal tissue. It is also indicated when root maturation is complete and the permanent restoration requires a post buildup. Special effort should be made to treat and retain the second primary molar, even if it has a necrotic pulp. Because replantation should be done as soon as possible after the injury, the dentist should not take time to extirpate the pulp before replantation. difficult to avoid the extrusion of filling materials beyond the root canals in all pulpectomy cases. The root canals and pulp chamber are filled with special dental materials, and a dental filling … A thick mix of the treatment paste should then be prepared, rolled into a point, and carried into the canal. If the avulsed tooth has been cared for properly, there is a small chance for revitalization even if the tooth is replanted within 1 hour after the injury. Contraindications for RCT in primary teeth are discussed lengthily in the literature [, Lateral and accessory canals exist in most primary molars and are more prevalent in mandibular molars compared with maxillary ones [, A RCT in a primary second molar with a poor prognosis is sometimes indicated, even if that tooth is maintained only until the first permanent molar has erupted, and then the primary molar is extracted and replaced with a space maintainer [. Removal of organic debris is the main purpose of canal instrumentation. After the canal has been filled, excess paste is removed, and an amalgam plugger is used to firmly pack the hardening paste into the filled canal. Apexification using apical barrier technique. Disadvantages: The cost for this procedure, followed by the crown (cap) (p. 146), which is necessary for strength, is moderate. Mechanical removal of remnants from the canal is performed using a series of 21 mm long K-type endodontic files (Unitek Corp., Monrovia, CA) up to file No. Figure 35.7. Restorations that do not use a post should be used whenever possible to replace missing tooth structure and serve as a retentive foundation. The use of calcium hydroxide as a root-canal–filling material was described previously in the discussion of apexification. Irrigation with normal saline before drying with appropriately sized sterile paper points (shown in Fig. The laser technique required less time for completion of the cleaning and shaping procedures when compared with both rotary or hand instrumentation [. Although zinc oxide–eugenol paste has been viewed as the traditional root canal filling material for primary teeth, results from multiple studies23-28 suggest that KRI paste (Pharmachemie AG, Zürich, Switzerland) may be preferable. Vitapex drawn as to the best pulpectomy material. - It decreases tooth pain. Objective To evaluate the success rate of pulpectomy of primary molars using four different root canal filling materials: ZOP as a new paste, Endoflas, Metapex, and ZOE. As aqueous vehicles favor a high degree of solubility, they will cause a depletion of the paste from the root canals, In vitro studies found that Metapex demonstrated minimal inhibition of 23 strains of bacteria isolated from infected root canals of primary molars and three nonstandard bacterial strains using agar diffusion assay [, Maisto’s paste, introduced in 1967, includes both zinc oxide and iodoform, with parachlorophenol camphor, lanolin, and thymol. The optimum duration of the calcium hydroxide treatment is unknown, but generally calcium hydroxide should be kept in the canal for at least 6 months or until root end closure (apical plug) occurs beyond 1 year. Cost: Cost of this procedure plus the crown (cap) (p. 146) required for strength may equal or exceed the cost of tooth removal and placement of a space maintainer. After the pulp tissue has been removed from the canals, a syringe is used to irrigate them with 3% hydrogen peroxide followed by sodium hypochlorite. Even though a few reports of revitalization exist, the chances for revitalization are remote at best. Excellent results have been observed in many cases. Researchers have now experimented with a new mixture consisting of propolis, which is a natural product with proven antibacterial and anti-inflammatory properties, and zinc oxide powder as a filling material in primary teeth. However, many teeth do not revitalize. An x-ray film may be necessary to allow evaluation of the success in filling the canals (Fig. Chawla HS, et al.Evaluation of a mixture of zinc oxide, calcium hydroxide and sodium fluoride as a new root canal filling material for primary teeth. It is unwise to maintain untreated infected primary teeth in the mouth. After a dentist or endodontist removes the damaged pulp from the tooth, the area inside the tooth is disinfected and then filled with an inert material. Risks: Occasionally the procedure fails in children, requiring removal of the tooth. 13-15). Many dentists prefer to use root canal instruments placed in a special rotary handpiece and nickel titanium files for root canal debridement. Definition. The inflamed or necrotic pulp is removed and access preparation is refined to make sure that entrance to all of the canals is possible and clearly visible. Root canal instrumentation may be facilitated with the judicious use of this mechanical technique, especially in canals that are difficult to negotiate with hand instruments. The aqueous, viscous, or oily vehicle used in the formulation of the root canal filling paste impacts the speed of ionic dissociation. 19-13). Primary molar roots are usually curved to allow for the development of the succedaneous tooth. Vitapex may be at least as effective as KRI paste, and Nurko and Garcí-Godoy21,24 have published some human reports. In primary teeth with irreversible pulpal changes, ZOE pulpectomies yielded similar outcomes as Vitapex and more favorable than Sealapex, a calcium hydroxide cement (SybronEndo, Orange, CA), although there was no agreement with regard to filling materials’ resorption . In the strictest sense, complete removal of the the pulp from the pulp chamber and canals is a pulpectomy. This procedure involves anesthetizing the animal, in this case a nonhuman primate, and placing it on a surgery table in dorsal recumbency. In A Consumer's Guide to Dentistry (Second Edition), 2002. The calcium hydroxide material used to fill the root canal should be replaced every 3 to 6 months until a decision is made to fill the canal with gutta-percha. 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