MODERATORS: Antonella Polimeni, Enrico Spinas
PEDIATRIC ENDODONTICS is considered to be an essential part of the clinicians competence in daily practice. The restorative and endodontic treatment of deciduous teeth is different from that of the permanent dentition. It is essential that the dentist is knowledgeable of the various phases of development of the deciduous tooth to identify the opportune moment to intervene and with the appropriate materials.
The materials and techniques currently available permit the practitioner to perform predictable procedures aimed at the preservation of the deciduous dentition until the time for its physiological exfoliation, guaranteeing the harmonious growth and development of the maxilla and mandible. The lecture will also explore the techniques of psychological approach used in treating the pedo patient that necessitates endodontic treatment. Various clinical cases will be shown.
Molar and incisor hypomineralization (MIH) have an ever increasing occurrence in the pediatric population and often creates doubts in diagnosis and subsequent therapy for the dental practitioner.
Histologically enamel defects can be classified as hypoplastic or hypomineralized lesions. Qualitative or quantitative enamel defects only become visible once the mineral deficit exceeds the sound enamel by 10%. Differential diagnosis of these lesions is fundamental in developing a correct therapeutic plan considering that the difficulty in managing these cases are multiple. Often these patients have teeth that are extremely hypersensitive creating an anxious and at times phobic patient while the enamel, due to a high concentration of organic substances, makes adhesion unpredictable therefore an unpredictable prognosis.
Amongst the most difficult pathologies of the enamel to manage are molar and incisor hypomineralization due to the complexity of the symptoms and the scarcity of literature on the treatment of the associated hypersensitivity.
Dental trauma to permanent teeth in young children with teeth with open apices is a common situation which dentist encounter regularly. The ideal outcome is continued root formation and successful root canal treatment since these teeth with incomplete root development have short roots with thin walls, which compromises their longevity. Through regenerative therapy, one can facilitate root development in previously immature teeth with necrotic pulps. This is a significant benefit over conventional root canal treatment and especially valuable for young patients, as teeth preservation is critical to their skeletal and dental development.
Regenerative endodontics is one of the most remarkable advancements in dentistry and there have been many regenerative endodontic protocols over the years and further research is required into this novel approach to apexogenesis to assess the long-term prognosis of these teeth. Current research on pulp regeneration is growing and provides exciting possibilities for greater biological approaches to endodontics in the future. In this lecture we will discuss the protocols and biomaterials used to increase the chance of a successful outcome.