Hello,
I am a first year pediatric dentistry resident.  I see many 6 year molars
that need endo which I refer as soon as I do the pulpotomy or pulpectomy.
Our clinic is in debate as to how to treat these teeth prior to referring
them out to an endodontist.  When the pulp is truly necrotic what should be
done vs.. if the pulp chamber is necrosed but the canals are still
hemorrhagic.  And then, what if the apex is open vs.. closed.  To what
extent should the puplotomy or pulpectomy be carried to and what should be
placed in the tooth (in the canals and onto the canals).  When is a
pulpotomy indicated over pulpectomy?  Thank you in advance for your
anticipated help with these questions.  I realize that some endodontists
subscribe t varying philosophies.  I would like to know what would be
considered "standard of care" by the endodontic community.
Sincerely,
Allen Pearson, DDS