Wound healing after pulpectomy
Healing regularity following pulpectomy characterized by an initial inflammatory reaction in the apical tissue injury caused by the cutting procedure. Residual pulp are often shabby and may even be lost in the process (57). If, by chance, root canal tool was pushed apical hole during a working definition of length or instrument channel, the apical termination of training should still be limited to 1-2 mm from the anatomical apex, to reduce the risk of periapical excess root filling material. In the absence of wound infection, reorganization happens soon. This includes the replacement of the damaged tissue connective tissue derived from the periapical region (39, 59). In the process, some internal or external root resorption may develop, repaired in the future. Patients may experience some tenderness immediately after pulpectomy. These symptoms disappear after a few days, along with the restoration of the apical tissue.
The materials used for filling root canals can disrupt the normal healing pattern, because of their annoying power, and as a result of years of inflammatory lesions.
In particular, this is the case when the root of the filling material is extruded into the residual pulp and periapical tissues, or in the uninstrumented apical consequences (27, 68). Inflammatory cells accumulate close to the root of the filling material and stay as long as the toxic components are produced. In the end, the material will be lined up off the fibrous connective tissue.
These lesions usually begins quietly, without causing discomfort to the patient. On overwhelms penetrated into the periapical tissues, fixators area can sometimes be found to limit the material, thus reflecting tissue irritation that occurs. The process of phagocytosis can eliminate excess root filling material, and sometimes also the material inside of the channel (see Chapter 12). Therefore, the answers to the filling of root material may remain for many years and avoid complete healing. A small excess of the root filling material does not cause extensive lesions: bacterial etiology should be suspected for a more extensive lesions.
It is not uncommon for dentin chips are removed from the walls of the channel during a Toolkit for displaced to the territory or Packed in respect of residual mass (Fig. 4.19). If infected, it is usually regarded as beneficial because dentin chips:
- separate the root of the filling material from the apical tissue;
- an important role in the formation of solid tissues of the barrier (81).
It should be emphasized that neither Packed dentin chips, nor apposition of hard tissues of the displaced dentin chips impenetrable bacteria and bacterial elements (71), so further treatment, for example. later access to the channel for the preparation of the post-Soviet space should be performed under aseptic conditions...