Pediatric Endodontic Therapy
Apexogenesis
This procedure encourages the root to continue development as the pulp is healed. Soft tissue is covered with medication to encourage growth. The tip of the root (apex) will continue to close as the child gets older. In turn, the walls of the root canal will thicken. If the pulp heals, no additional treatment will be necessary. The more mature the root becomes, the better the chance to save the tooth.
Apexification
In this case, the unhealthy pulp is removed. The endodontists place medication into the root to help a hard tissue form near the root tip. This hardened tissue provides a barrier for the root canal filling. At this point, the root canal walls will not continue to develop, making the tooth susceptible to fractures. So it is important to have the tooth properly restored by your dentist.
Revascularization/Regenerative Endodontics
Regenerative endodontics is one of the most exciting developments in dentistry today and endodontists are at the forefront of this cutting-edge research. Regenerative endodontics uses the concept of tissue engineering to restore the root canals to a healthy state, allowing for continued development of the root and surrounding tissue. Endodontists’ knowledge in the fields of pulp biology, dental trauma and tissue engineering can be applied to deliver biologically based regenerative endodontic treatment of necrotic immature permanent teeth resulting in continued root development, increased thickness in the dentinal walls and apical closure. These developments in regeneration of a functional pulp-dentin complex have a promising impact on efforts to retain the natural dentition, the ultimate goal of endodontic treatment.
Do traumatic dental injuries differ in children?
Chipped primary (baby) teeth can be esthetically restored. Dislodged primary teeth can, in rare cases, be repositioned. However, primary teeth that have been knocked out typically should not be replanted. This is because the replantation of a knocked-out primary tooth may cause further and permanent damage to the underlying permanent tooth that is growing inside the bone.
Children’s permanent teeth that are not fully developed at the time of the injury need special attention and careful follow up, but not all of them will need root canal treatment. In an immature permanent tooth, the blood supply to the tooth and the presence of stem cells in the region may enable the endodontist to stimulate continued root growth.
Endodontists have the knowledge and skill to treat incompletely formed roots in children so that, in some instances, the roots can continue to develop.