Efficacy of Treatment Approaches for Immature Permanent Teeth with Pulp Necrosis

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CE Hours: 0

Description: Regenerative endodontic treatment of immature teeth is now advocated as first treatment choice for immature teeth with pulp necrosis. Traditionally, calcium hydroxide apexification and more recently MTA apical barrier techniques are alternative approaches. A disadvantage of these approaches is no further root development and a belief that calcium hydroxide may weaken teeth. The veracity of that claim will be examined. Clinical outcomes regarding resolution of signs and symptoms of infection are similar for all approaches. Immature teeth with pulp necrosis treated with REPs generally show further root maturation although the results are variable. Furthermore, patient-based criteria such as tooth discoloration, indications for changing the treatment option, and number of treatment appointments are all important parameters for discussion before electing the appropriate treatment plan for the management of immature teeth with pulp necrosis. Recommendations for which treatment approach are dependent on aesthetic requirements and stage of root development.

  • Describe the parameters of success in the treatment of immature teeth
  • Evaluate patient and clinician based outcome measures.
  • Evaluate the efficacy of three treatment approaches for immature permanent teeth with pulp necrosis


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Bill Kahler, DClinDent., Ph.D.

Bill maintains a full time specialist private practice restricted to Endodontics in Brisbane and Toowoomba, Australia. He works in a dedicated trauma clinic for Queensland Health. In addition, Bill holds an honorary Associate Professor title at the University of Queensland. He is a Board member of the International Association of Dental Traumatology and is an author on the ‘IADT Guidelines for management of traumatic dental injuries’. He graduated DClinDent (Endo) from the University of Adelaide and has a PhD from the University of Sydney as well as numerous Fellowships. Bill has published more than 70 papers in international dental, material science and engineering journals. His papers are cited as reference texts by the American Association of Endodontists and the International Association of Dental Traumatology for the treatment of dental trauma and regenerative endodontic procedures. Bill is a contributing author for book chapters on endodontic outcomes and dental trauma, including “Pathways of the Pulp 12 edition” and the “Textbook and Color Atlas of Traumatic Injuries to the Teeth”. He has lectured extensively nationally and internationally and has numerous international research collaborations in every continent.

Bill Kahler, DClinDent., Ph.D.

In accordance with this policy, I declare that I have NO past or present proprietary or relevant financial relationship or receive gifts in kind (including soft intangible remuneration), consulting position or affiliation, or other personal interest of any nature or kind in any product, service, course and/or company, or in any firm beneficially associated therewith.