Dental Code D3220: Therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction and application of medicament

Dental Code D3220 pertains to a therapeutic pulpotomy procedure, excluding the final restoration, which involves the removal of the pulp tissue located coronal to the dentinocemental junction and the application of a medicament. 

On average, patients pay $200 for this D3220 service at the dentist's office, with as little as $60 charged for this in less expensive cities and as much as $300 in more expensive cities.

Low cost of living	Medium cost of living	High cost of living
Memphis (Tennessee), Cincinnati (Ohio)	Miami (Florida), Denver (Colorado), Austin (Texas)	(New York (New York), San Francisco (California)
$60	$200	$300

However, the price for the service D3220 depends not only on the region where you live, but also varies from dentist to dentist. Therefore, it makes sense to compare prices before choosing a dentist. The best way to do this price comparison is at Dr. BestPrice and save a lot of money. 

Dental Code D3220 specifically refers to a therapeutic pulpotomy, a procedure performed when the pulp tissue within a tooth's crown is infected, inflamed, or injured, but the root structure remains healthy. The pulpotomy aims to remove the affected pulp tissue, alleviate pain, and promote healing while preserving the vitality of the remaining pulp. The procedure is typically performed on primary (baby) teeth or permanent teeth with immature root development.

Before initiating a therapeutic pulpotomy, a comprehensive examination and diagnosis are essential. The dentist evaluates the tooth's condition, considering factors such as patient symptoms (e.g., pain, sensitivity), clinical signs (e.g., swelling, discoloration), and radiographic findings. The decision to perform a pulpotomy is based on the extent of pulp involvement, the presence of irreversible inflammation or infection, and the overall oral health of the patient.

Patient Symptoms: The dentist evaluates the patient's symptoms, such as pain or sensitivity, which may indicate pulp inflammation or infection. Patients might experience spontaneous toothache, pain while biting or chewing, or heightened sensitivity to hot or cold stimuli.

Clinical Signs: Clinical signs observed during the examination can provide valuable insights into the tooth's health. Swelling or inflammation in the surrounding gum tissue, discoloration of the tooth (such as gray or black discoloration), or the presence of a draining sinus tract can indicate underlying pulp pathology.

Radiographic Findings: Dental X-rays are an essential tool in diagnosing pulp conditions. They enable the dentist to assess the extent of pulp involvement, identify any signs of infection or inflammation, and evaluate the tooth's overall health. Radiographic changes, such as widening of the pulp chamber or presence of periapical radiolucency (indicating bone destruction around the tooth's root), can aid in diagnosis.

To ensure patient comfort during the procedure, local anesthesia is administered around the affected tooth. This numbs the area and prevents pain during the pulpotomy. Proper isolation is crucial to maintain a sterile and dry environment, ensuring optimal conditions for the procedure. Dental dams, which are thin latex or non-latex sheets, are commonly used to isolate the tooth, protecting the surrounding oral tissues from contamination.

Once anesthesia and isolation are achieved, the dentist gains access to the pulp chamber by creating an opening in the tooth's crown using dental drills or other appropriate instruments. The access cavity allows direct visualization and removal of the affected pulp tissue. The dentist carefully and gently removes the decayed or infected pulp tissue using specialized instruments, such as barbed broaches or pulp extractors. The goal is to thoroughly clean the pulp chamber, reaching the level of the dentinocemental junction.

After the pulpal tissue removal, achieving hemostasis is vital to control any bleeding within the pulp chamber. Hemostatic agents, such as sterile cotton pellets or mineral-rich materials, may be applied to the bleeding site to assist in clot formation. Once hemostasis is achieved, a suitable medication is applied to the remaining healthy pulp tissue. Commonly used medications include mineral trioxide aggregate (MTA) or calcium hydroxide. These materials have antibacterial properties and promote pulp healing and regeneration. The medicament is carefully placed over the exposed pulp, ensuring complete coverage and sealing.

Following the application of the medicament, a temporary restoration is placed to seal the access cavity and protect the treated tooth. This temporary restoration acts as a barrier against bacterial ingress and helps maintain the integrity of the tooth structure until the final restoration can be performed. The restoration can be made of temporary filling materials, such as dental cement or composite resin, and is shaped and contoured to fit the tooth's anatomy.

After the therapeutic pulpotomy, regular follow-up appointments are necessary to monitor the tooth's healing progress. The dentist will assess the tooth's response to treatment, evaluate any symptoms, and ensure there are no signs of reinfection. Depending on the tooth's condition, a final restoration may be required at a subsequent visit to restore its form and function. This may involve the placement of a dental filling, crown, or other appropriate restoration to protect the tooth and prevent further damage.

Dental Code D3220 encompasses a therapeutic pulpotomy procedure, excluding the final restoration, aimed at removing the infected or inflamed pulp tissue located coronal to the dentinocemental junction. The process involves a thorough diagnosis, administration of local anesthesia, proper isolation, access to the pulp chamber, removal of affected pulp tissue, achieving hemostasis, application of a suitable medicament, placement of a temporary restoration, and subsequent follow-up. It is crucial to consult with a qualified dentist or endodontist to determine if a therapeutic pulpotomy is the appropriate course of action based on individual oral health needs.

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