ENDODONTIC considerations in pediatric dentistry: a clinical perspective

The deciduous tooth often presents post-carious pulpal implications that require endodontic treatment.

The deciduous tooth goes through different stages during which it witnesses changes of anatomical and physiological nature: the root undergoes resorption and the pulp’s reactive potential is diminished or even lost.

The tooth has also to be considered within the physiopathological context of the child. The age, general health, and the compliance of the young patient (and sometimes that of the parents) are also factors to be considered before undertaking any treatment procedure.

The aim of pulp therapy in the primary dentition is to retain the primary tooth as a fully functional part of the dentition, allowing at the same time for mastication, phonation, swallowing, and the preservation of the space required for the eruption of the permanent tooth.

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Furthermore, maintaining esthetics will avoid psychological problems related to the loss of teeth. Clinically, the choice of pulp therapy is based on semeiology despite the assessment difficulties and imprecision of pulp tests related to deciduous dentition.

The choice between pulpotomy and pulpectomy is generally based on the severity of the symptoms clinically and/or radiographically. When indicated, pulpotomy of the deciduous tooth is relatively an easy procedure with generally good clinical results.

Pulpectomy on the other hand is a heavier treatment for the child and is more complicated due to anatomical complexities that are not found in the permanent tooth.


Hani F. Ounsi / Dina Debaybo / Ziad Salameh / Anis Chebaro / Hassan Bassam

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