Octopotomy in children, what is it?

The octomy is a conservative treatment that eliminates only the inflamed pulp in the dental crown, preserving the vitality of the root. It is used in temporary and permanent young teeth, especially after deep caries or trauma. It is less invasive than a policy and helps maintain functional tooth while developing.

The octomy is a procedure widely used in pediatric dentistry in temporary teeth and in young permanent teeth, whose main objective is preserve the vitality of the root pulp (root), after a pulp exposure for a decay or for a trauma.

The tooth pulp is the part of the tooth, which is soft and that gives it vitality, it is a vascular and nervous tissue.

The octomy consists of the Elimination of the pulp located in the crown, inflamed or infected, preserving the vital root pulp. It is mainly done in primary teeth with extensive caries or in permanent young teeth with immature apices (not completely formed roots).

When is it indicated?

• Deep caries that contact the pulp or close to the pulp.
• These deep caries may have already caused dentalgia symptoms, Reversible pulpitis with vital toothwithout causing a phlegmon.
• Traumatic pulp exposure.

The objective is to maintain the vitality of the root pulp, avoiding the progression of the pathology and allowing root development (not formed) in immature teeth. Professional Dental Insurance dentists of Mapfre will help you in this and other processes of pediatric dentistry.

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Types of octopotomy

Classical octomy (in primary teeth)

The coronal pulp followed by application of agents such as:

• MTA (mineral trioxide), biocompatible and bioactive material, which can be placed directly on the pulp to preserve its vitality and stimulate dentin formation, creating a calcified barrier.
• Formocresol was the most used material in the pediatric dentistry, composed of formaline, cresol and glycerin. Due to the doubts regarding its toxicity it is being replaced by other materials. It acts as a disinfectant and mummifies the pulp tissue.
• Ferric sulfate is used as an alternative to formocresol, to help control the bleeding of the pulp and favor the formation of a stable clot. Recall that the pulp is made up of blood vessels and nerve endings fundamentally.
• Crown restoration: If the crown affectation is important, it is restored with a stainless steel crown or with a functional shutter (filling).
• Preferred material: MTA, due to its high success rate and biocompatibility and stainless steel crown.

Partial octomy by cfariosase exposure

Indications: Young permanent teeth with carious exposure and controlled bleeding.

Partial elimination (1–3 mm) of inflamed pulp tissue Under a carious exposure.

Materials:

• Mta.
• Calcium hydroxide can be applied on the pulp directly or on the dentin in case a fine layer subtracts before reaching the pulp, stimulates the formation of secondary or repairing dentin.
• Very versatile dental glass ionomer that is formed from the reaction of a fluoroaluminosylicate glass powder and a polyacrylic acid fluid, has a function of sealed and releases fluoride that mineralizes.
• Crown restoration: If the crown affectation is important, it is restored with a stainless steel crown or with a functional shutter (filling).

Partial octopotomy due to traumatic exposure

Similar procedure to the previous one, but after a tooth trauma. Indication, in permanent young teeth with traumatic exposure, especially with open apex (immature roots not fully formed).

• Materials: White MTA (to avoid discoloration), calcium hydroxide.
• The goal is Preserve vitality pulp and allow root development.
• Crown restoration as in the previous procedures.
• All these procedures are performed under local anesthesia and are painless.

What is the difference between an octopotomy and a policy?

The octomy, in its different forms, represents a Conservative and effective strategy to preserve vitality Pulp in young or primary teeth. Their correct indication and execution can avoid more invasive treatments such as policy, prolonging the life of the tooth and favoring the development of the roots.

The policy completely eliminate the pulp both at the crown level and the rootit would be the equivalent of an endodontics of an adult permanent tooth. The tooth completely loses its vitality.

The following table explains the differences in a graphic form:

Differences	Octopotomy	Pulpectomy
Treatment extension	Only coronal pulp is eliminated	The entire pulp is removed (coronal and root)
Pulp vitality	Vital root pulp is preserved	It is done when the pulp is necrotic (not vital) or infected
Indications	Vital pulp or reversible pulpitis	Necrotic pulp (not vital), irreversible or with abscess (pus collection)
Aim	Maintain vitality and function	Eliminate infection preserve the tooth.
Materials used	Maintain vitality and function	Sodium hypochlorite, obturation materials
Application	Primary and permanent young teeth	Primary teeth with necrosis (not vital)

The octomy, in its different forms, represents a conservative and effective strategy to preserve vitality pulp in young or primary teeth. Their correct indication and execution can avoid more invasive treatments such as policy, prolonging the life of the tooth and favoring root development.

The Pediatric Odonto, is the specialist who is highly trained and has the necessary experience to treat children, ensuring that the procedure is carried out in a way safe, effective and with the least possible stress for the little. A pediatric dentus not only handles specific techniques for temporary teeth, but also knows how to create a friendly and reassuring environment, making the dentist visit a positive experience for your child.

What you should know …

• The octomy is a conservative treatment that eliminates only the inflamed pulp in the tooth crown, preserving the vital root pulp, to maintain vitality and allow development in temporary and permanent young teeth.
• Different biocompatible materials (such as MTA and calcium hydroxide) are used and the procedure varies according to the type of octopotomy and cause (caries or trauma).
• The octomy is different and less invasive than the policy, which eliminates the entire pulp; This treatment avoids more aggressive procedures and prolongs the life of the tooth, especially in children.