Occasionally the young pulp of permanent developing teeth may become infected or necrotic due to caries or trauma. Traditionally the treatment of these teeth had been approached through direct pulp capping, pulpotomy, apexogenesis or apexification procedures according to different magnitudes of pulpal damage. The indications, objectives, and type of pulpal therapy depend on whether the pulp is vital or non-vital, based on the clinical diagnosis of normal pulp, reversibly inflamed pulp, irreversibly inflamed pulp or totally necrotic pulp. The greater the pulp damage of the developing permanent dentition is, the greater the challenge. Recently, bioactive materials and regenerative concepts were introduced in order to increase the prognosis of compromised necrotic developing permanent teeth.
Learning objective: the re-establishment of a functional vital tissue that will foster continued root development, dentinal wall thickening, and immune competency. In this lecture single and multiple steps, regenerative protocols will be discussed through the long term observation of relevant cases.