Treatment
Asymptomatic Incidental Finding
Root canal treatment is indicated to prevent progression
- • Patient education regarding diagnosis and prognosis without treatment
- • Root canal treatment scheduled electively
- • Removal of all caries and defective restoration
- • Complete canal debridement and obturation
- • Crown restoration following root canal treatment
Hyperplastic Pulpitis (Pulp Polyp)
Excision of polyp followed by root canal treatment
- • Excise polyp with scalpel or electrosurgery to expose carious defect
- • Achieve hemostasis with pressure or electrosurgery
- • Complete caries removal
- • Pulpectomy and root canal instrumentation
- • Intracanal calcium hydroxide dressing if hemorrhage control inadequate
- • Final obturation and crown restoration at subsequent appointment
Exacerbated (Acute-on-Chronic)
Emergency management as for acute irreversible pulpitis
- • Same protocol as acute irreversible pulpitis emergency
- • Pulp extirpation with immediate pain relief
- • Intraligamentary or intraosseous anesthesia if IAN block inadequate
- • Temporary restoration pending definitive root canal treatment