title: Management of incompletely developed teeth requiring root canal treatment.
abstract: Endodontic management of the permanent immature tooth continues to be a challenge for both clinicians and researchers. Clinical concerns are primarily related to achieving adequate levels of disinfection as 'aggressive' instrumentation is contraindicated and hence there exists a much greater reliance on endodontic irrigants and medicaments. The open apex has also presented obturation difficulties, notably in controlling length. Long-term apexification procedures with calcium hydroxide have proven to be successful in retaining many of these immature infected teeth but due to their thin dentinal walls and perceived problems associated with long-term placement of calcium hydroxide, they have been found to be prone to cervical fracture and subsequent tooth loss. In recent years there has developed an increasing interest in the possibility of 'regenerating' pulp tissue in an infected immature tooth. It is apparent that although the philosophy and hope of 'regeneration' is commendable, recent histologic studies appear to suggest that the calcified material deposited on the canal wall is bone/cementum rather than dentine, hence the absence of pulp tissue with or without an odontoblast layer.
authors.affiliation: Private Practice, Burwood, New South Wales, Australia.
authors.forename: S C
authors.initials: SC
authors.lastname: Harlamb
mesh_terms: D017607:Aluminum Compounds / Q000627:therapeutic use; D056624:Apexification / Q000379:methods*; D017610:Calcium Compounds / Q000627:therapeutic use; D002126:Calcium Hydroxide / Q000627:therapeutic use; D004338:Drug Combinations; D006801:Humans; D009805:Odontogenesis / Q000502:physiology; D010087:Oxides / Q000627:therapeutic use; D011672:Pulpotomy / Q000379:methods; D012038:Regeneration / Q000502:physiology; D012388:Root Canal Irrigants / Q000627:therapeutic use; D017640:Silicates / Q000627:therapeutic use; D019227:Tooth Apex / Q000473:pathology / Q000503:physiopathology*; D018677:Tooth Injuries / Q000150:complications* / Q000503:physiopathology
chemical_list: D017607:Aluminum Compounds; D017610:Calcium Compounds; D004338:Drug Combinations; D010087:Oxides; D012388:Root Canal Irrigants; D017640:Silicates; C086631:mineral trioxide aggregate; D002126:Calcium Hydroxide
keywords: Apexification; immature teeth; regenerative endodontic procedure; root canal; trauma