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Pulp therapy and root canal treatment techniques in immature permanent teeth: an update

British Dental Journal volume 232, pages 524–530 (2022)Cite this article

Abstract

Background According to the Children's Dental Health Survey 2013, around one in ten children in Wales, Northern Ireland and England will have sustained dental trauma to a permanent incisor by the of age 15. Management of an exposed pulp in an immature permanent incisor is often urgent and has an impact on the long-term outcome of the tooth; therefore, it is essential that general dental practitioners feel confident in managing such a scenario to achieve an optimal outcome. This paper discusses the indications, technique, materials and outcomes.

Aims This article aims to review the literature, which discusses various treatment modalities and materials for pulpal therapy and root canal treatment in the immature permanent tooth.

Method Electronic searches were limited to English language, human studies, published within the past five years and the medical subject heading terms used were: direct pulp capping, apexogenesis, Cvek pulpotomy, full pulpotomy/pulpectomy, partial pulpotomy, apexification, non-vital pulp therapy and mineral trioxide aggregate apexification. Older, seminal articles identified through the references sections have also been included.

Conclusion A number of options are available for the management of immature permanent teeth that have suffered an insult such as caries or trauma. This paper reviews the various methods of pulpal treatment, preservation therapy and root canal treatment options depending on the extent of the damage.

Key points

  • Highlights the management options for pulpal therapy and root canal treatment in immature permanent teeth.

  • Discusses the techniques used for carrying out pulp therapy in immature permanent teeth.

  • Discusses the literature and guidance regarding pulpal therapy in immature permanent teeth.

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Authors and Affiliations

  1. Dental Core Trainee 3 in Paediatric Dentistry and Paediatric Oral and Maxillofacial Surgery, Birmingham Women’s and Children’s NHS Foundation Trust, UK

    Anika Shah

  2. Dental Core Trainee 3 in Oral and Maxillofacial Surgery, Mid and South Essex NHS Foundation Trust, UK

    Rachel Peacock

  3. Consultant in Restorative Dentistry, St George’s Hospital NHS Foundation Trust, UK

    Shiyana Eliyas

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  2. Rachel Peacock
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  3. Shiyana Eliyas
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Contributions

Anika Shah: first author and corresponding author; involved in initial planning and establishment of MESH terms for literature search; reviewed literature and used this to write the abstract, introduction and non-vital pulp therapy techniques section; digital editing of hand-drawn diagrams; and revisions. Rachel Peacock: first author; involved in initial planning and establishment of MESH terms for literature search; reviewed literature and used this to write the abstract, introduction, vital pulp therapy techniques section and conclusion; illustration of original hand-drawn diagrams; and revisions. Shiyana Eliyas: second author; project supervisor; involved in reviewing article and editing; provided guidance on direction of the article.

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Correspondence to Anika Shah.

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Shah, A., Peacock, R. & Eliyas, S. Pulp therapy and root canal treatment techniques in immature permanent teeth: an update. Br Dent J 232, 524–530 (2022). https://doi.org/10.1038/s41415-022-4139-4

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