Prior to the eruption of first permanent molars, decisions concerning badly decayed second primary molars can be difficult in the dental office. Which approach do you prefer (extract the second primary molar or attempt pulpectomy)?
Definitely to try to restore the primary teeth is better than extracting them
Extracting the primary tooth will cause mesial tipping of the newly erupting permanent molar so try to keep the primary tooth or if the tooth is non restorable , extract it and use distal shoe space maintainer till the eruption of permanent molar then you can use band and loop space maintainer till time of eruption of second premolar
Thank you Raya Al-Naimi and Rasha Alfhadi for your valuable input.
Since the distal shoe is very difficult to construct and needs very good oral hygiene and the second primary molar is restorable i prefere to treat it by pulpectomy until the eruption of first permanent molar. At that time extract the the second primary molar and constract the space maintainer.
The Calcium hydroxide will act as a temporary treatment until the eruption of the first permanent molar.
Follow-up and periodic examination is needed.
Thank you Bushra Resheed for your answer, pulpectomy is for sure an option for pulpally involved second primary molar in cooperative children. However, the difficult decision comes when cooperation isn't great considering also the difficulties associated with the distal shoe which you mentioned.
Try to keep the primary tooth by pulpectomy or extract it and use space maintainer till the eruption of permanent molar
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