SP-22 Dilemmas in Managing Immature Teeth

3.33 (3 votes)

CE: 1.0

Course Description: 

Immature teeth with pulpless and infected root canal systems and apical periodontitis or apical abscesses pose significant management dilemmas for clinicians. These cases may result from a dens evaginatus (typically mandibular premolars) or from trauma to the tooth at a young age (typically maxillary incisors). These two scenarios are quite different and will have different possible healing responses. The traumatised tooth may also be associated with trauma to the periapical tissues whereas the dens evaginatus cases do not have this same periapical damage. Clinicians have three options to manage such teeth - apexification using calcium hydroxide, placing an “apical plug” (such as MTA or other bioceramic material), or a repair procedure (often called “regeneration” or “revascularisation” - but these terms are usually not applicable to the trauma situation). This presentation will explore the concepts behind these options and will discuss the findings reported in the literature. The outcomes of these three options, their longevity, practical aspects and suitability for re-treatment will be compared to enable clinicians to choose the appropriate management option for individual cases.

At the conclusion, participants should be able to:

  • Describe the management options for pulpless, infected immature teeth.
  • Evaluate the advantages and disadvantages of the three management options for pulpless, infected immature teeth.
  • Choose the appropriate management option for the various situations where immature teeth have become pulpless and infected.


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7 Questions
5 Questions  |  Unlimited attempts  |  4/5 points to pass
5 Questions  |  Unlimited attempts  |  4/5 points to pass
1.00 credit  |  Certificate available
1.00 credit  |  Certificate available

Paul V. Abbott, B.D.Sc., M.D.S., FRACDS(Endo)

Prof. Paul Abbott is the Winthrop Professor of Clinical Dentistry at The University of Western Australia where he co-ordinates and teaches both the undergraduate and postgraduate endodontic programmes. From 1986-2002, Prof. Abbott worked mainly in private specialist Endodontic practice with part-time university appointments. In 2003, he was appointed Dean of the School of Dentistry and Director of the Oral Health Centre of WA, positions he held until 2009. From 2010-2012, he was Director of Postgraduate Studies and Research. Now he concentrates on teaching and research, as well as working part-time in private practice. He has presented over 650 lectures and courses in 40 countries. He has published 115 articles in refereed journals and 18 textbook chapters. He serves on Editorial Boards and Scientific Review Panels of 17 journals. Prof. Abbott is a Past President of the International Federation of Endodontic Associations, the Asian Pacific Endodontic Confederation and the Australian Society of Endodontology. He has been a Director of the Australian Dental Council and is now a member of the Dental Board of Australia. In 2004, he was awarded the University of Western Australia’s Excellence in Teaching Award and in 2008 the Australian Dental Association awarded him their Service Medallion.

Paul Vincent. Abbott, B,D.Sc., MDS, FRACDS

I declare I have a 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, as indicated: OzDent Pty Ltd () : Consultant, Honorarium