After proper diagnosis and profound local anesthesia, a dentist can then proceed with clinical conventional endodontic treatment in performing a pulpectomy (the complete removal of the pulp tissue) while using a rubber dam to isolate the treatment tooth. For a pulpectomy, chemomechanical preparation of the entire root-canal system should be performed. This type of chemomechanical canal preparation involves using endodontic files, sodium hypochlorite, and ethylenediaminetetraacetic acid (EDTA) gel placement on each file (Figure 8). Also, if the dentist is not doing a single-visit treatment, calcium hydroxide should be placed in the canal(s) before temporizing the tooth in cases of irreversible pulpitis.16 If the canal(s) is/are necrotic, it is recommended to also irrigate with chlorhexidine before placing a calcium hydroxide in the canal and temporizing the tooth.31
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