An MTA pulpotomy is a dental procedure for baby teeth when a deep cavity reaches the tooth’s inner pulp. The goal is to save the tooth from extraction by removing the infected part of the pulp and placing a specialized material to help the remaining tissue heal. Preserving the tooth allows it to serve its functions until it naturally falls out.
The Purpose of a Pulpotomy
A baby tooth has an outer enamel, a middle layer of dentin, and an inner pulp with nerves and blood vessels. When a cavity progresses through these layers and reaches the pulp, it can cause infection. A pulpotomy removes the inflamed pulp tissue from the tooth’s crown while leaving the healthy pulp in the roots untouched.
Saving a baby tooth is important for the development of permanent teeth. Baby molars act as natural space holders, guiding permanent teeth into their correct positions. If a baby molar is lost too early, adjacent teeth can drift into the empty space, causing crowding and alignment problems for the permanent teeth.
The MTA Pulpotomy Procedure
The procedure begins with numbing the tooth and surrounding gum tissue. A rubber dam is often placed to isolate the tooth and keep it dry. The dentist removes the decay, creates a small opening to access the pulp chamber, and then carefully removes only the infected pulp tissue within the crown.
After the affected tissue is removed, the area is cleaned. Mineral Trioxide Aggregate (MTA), a biocompatible material, is placed directly over the remaining healthy pulp. MTA seals the area to prevent bacterial leakage and stimulates the formation of a hard tissue barrier, which promotes healing.
Once the MTA is in place, a final restoration is needed to protect the weakened tooth. A pediatric dental crown, such as a stainless steel crown, is cemented over the tooth. This crown protects the tooth from fracture, allowing it to function normally until the permanent tooth replaces it.
Post-Procedure Care and Recovery
Following the procedure, the local anesthetic will take a couple of hours to wear off. It is important to monitor the child to prevent them from accidentally biting their lip, cheek, or tongue while it is still numb. Some minor discomfort is normal once the numbness subsides, and over-the-counter pain medication can be used if needed.
Provide a soft diet for the first day to avoid pressure on the new crown; foods like yogurt or mashed potatoes are good options. The child can return to a normal diet the next day. Long-term care involves regular brushing and flossing, just like any other tooth.
Comparing MTA to Other Materials
Historically, a material called formocresol was widely used in pulpotomy procedures, but concerns have been raised about its properties. Modern pediatric dentistry has shifted towards using MTA because of its distinct advantages and high success rates in primary teeth.
MTA is highly biocompatible, meaning it is well-tolerated by the body’s tissues and less likely to cause irritation. Unlike older materials, its ability to promote natural healing and form a protective hard tissue layer makes it a preferred choice for saving infected baby teeth.