SP-44 When Is Root Canal Treatment Indicated After Trauma to a Tooth?
CE Hours: 1.5
Description: Traumatic dental injuries are potentially very complex and can lead to a number of different responses of the pulp and peri-radicular tissues. A thorough understanding of the various potential pulp responses is essential so appropriate management can be undertaken. Following many injuries, the pulp may survive – but this can only occur if the pulp is managed appropriately at the emergency visit which includes not removing the pulp in many cases! However, there are some specific injuries where pulp survival is predictably unlikely. If the pulp necroses and becomes infected, then there is the potential for external inflammatory resorption to develop if there has also been damage to the periodontal ligament and/or external root surface of the tooth. In such situations, a preventive approach can be used to prevent this resorption from developing. A key factor is to recognize which specific injuries make teeth susceptible to this type of resorption. Hence, understanding and knowing when and when not to commence root canal treatment after a traumatic dental injury is essential to ensure better outcomes and prognoses for traumatized teeth. This lecture will review the literature and provide guidelines for practitioners regarding when and when not commence root canal treatment.
Learning Objectives:
- Discuss the various responses of the pulp following trauma to a tooth.
- Explain why some pulps survive and others do not survive after trauma to a tooth, and identify those teeth where pulp survival is unlikely.
- Discuss when and when not to commence root canal treatment following trauma to a tooth.
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Paul V. Abbott, B.D.Sc., M.D.S., FRACDS(Endo)
Paul Abbott is Emeritus Professor of Dentistry at The University of Western Australia. He is a Specialist Endodontist with over 45 years of clinical practice experience. Prior to taking a full-time University position in 2002, he spent 17 years in private specialist endodontic practice and he also held part-time academic positions at The University of Western Australia and The University of Melbourne. He was Dean and Head of the School of Dentistry at The University of Western Australia and Director of the Oral Health Centre of Western Australia from 2003-2009. He has presented over 1000 lectures and courses in 52 countries. He has over 420 publications with 259 articles in refereed journals, 25 textbook chapters and 51 Newsletter articles. From 2015-2022, he was the Editor-in-Chief of the international journal Dental Traumatology. Prof. Abbott’s main research and clinical interests revolve around dental traumatology, tooth resorption, and the diagnosis and management of pulp, root canal and peri-radicular conditions, with particular emphasis on pain control and disinfection of the root canal system. He has received numerous awards for his teaching and service to the dental profession, including Honorary Life Memberships of several professional societies and associations. In 2015, he was appointed by the Governor-General of Australia as an Officer of the Order of Australia, and in 2024, he received the Jens O. Andreasen Lifetime Achievement Award in Dental Traumatology from the International Association for Dental Traumatology. At this year's Annual Session, he will receive the Louis I. Grossman Award from the AAE in recognition of his cumulative publications of significant research studies that have made an extraordinary contribution to endodontology.
Disclosure(s): OzDent Pty Ltd: Consultant/Scientific Advisor (Ongoing), Honorarium (Ongoing), Other Research Support (includes receipt of drugs, supplies, equipment or other in-kind support) (Ongoing), Speaker/Honoraria (includes speakers bureau, symposia, and expert witness) (Ongoing)