Injuries to children’s teeth (Immature Teeth)

An injured immature tooth may need one of the following procedures to improve the chances of saving the tooth:

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 doctors 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/Pulpal Regeneration

Children between seven and 12 years old may not need Endodontic Therapy (root canal treatment) since their teeth are still developing. For those patients, an endodontist or dentist will monitor the healing carefully and intervene immediately if any unfavorable changes appear. Therefore, multiple follow-up appointments are likely to be needed. New research indicates that stem cells present in the pulps of young people can be stimulated to complete root growth and heal the pulp following injuries or infection.

Pulpal revascularization will soon become the standard of care for the treatment of immature roots. This procedure has shown to revitalize or revascularize previously necrotic (dead) pulpal tissue and allow the immature tooth to complete its development. This procedure is at the forefront of tissue engineering in dentistry.

The dental pulp has been identified as a potential source for stem cells, and pulpal revascularization could be summarized as dentistry’s initial treatment protocol for tissue engineering/stem cell type therapy. Cutting edge research is currently developing techniques that will allow us to grow new pulp back into the roots of young undeveloped teeth, using a patient’s own stem cells.

In the past, traditional root canal therapy would leave these teeth with thin roots that were susceptible to fracture. However, when successful, regenerative endodontics allows continued normal root development.