Implications of root, pulp chamber, and canal anatomy on pulpotomy and revitalization procedures

Ahmed HMA, El-karim I, Duncan HF, Krastl G, Galler KM (2023)

Publication Type: Journal article, Review article

Publication year: 2023

Journal

Clinical Oral Investigations Springer Verlag (Germany)

Book Volume: 27

Pages Range: 6357-6369

Journal Issue: 11

DOI: 10.1007/s00784-023-05284-9

Abstract

Objectives: This review aims to discuss the implications of anatomy of the root, pulp chamber, and canals on pulpotomy and revitalization procedures (RPs) as treatment alternatives to root canal treatment procedures. Methods: This narrative review was undertaken to address two main questions – why remove vital pulp tissue in teeth with complex canal anatomy when it can be preserved? And why replace the necrotic pulp in teeth with mature roots with a synthetic material when we can revitalize? This review also aims to discuss anatomical challenges with pulpotomy and revitalization procedures. Results: Maintaining the vitality of the pulp via partial or full pulpotomy procedures avoids the multiple potential challenges faced by clinicians during root canal treatment. However, carrying out pulpotomy procedures requires a meticulous understanding of the pulp chamber anatomy, which varies from tooth to tooth. Literature shows an increased interest in the application of RPs in teeth with mature roots; however, to date, the relation between the complexity of the root canal system and outcomes of RPs in necrotic multi-rooted teeth with mature roots is unclear and requires further robust comparative research and long-term follow-up. Conclusions: Whenever indicated, pulpotomy procedures are viable treatment options for vital teeth with mature roots; however, comparative, adequately powered studies with long-term follow-up are needed as a priority in this area. RPs show promising outcomes for necrotic teeth with mature roots that warrant more evidence in different tooth types with long-term follow-ups. Clinical relevance: Clinicians should be aware of the pulp chamber anatomy, which is subject to morphological changes by age or as a defensive mechanism against microbial irritation, before practicing partial and full pulpotomy procedures. RP is a promising treatment option for teeth with immature roots, but more evidence is needed for its applications in teeth with mature roots. A universal consensus and considerably more robust evidence are needed for the standardization of RPs in teeth with mature roots.

Authors with CRIS profile

Kerstin Martina Galler Lehrstuhl für Zahn-,Mund- und Kieferheilkunde, insbesondere Zahnerhaltung, Parodontologie und Kinderzahnheilkunde

Involved external institutions

University of Malaya (UM) / Universiti Malaya MY Malaysia (MY) Dublin Dental University Hospital IE Ireland (IE) Queen's University GB United Kingdom (GB) Universitätsklinikum Würzburg DE Germany (DE)

How to cite

APA:

Ahmed, H.M.A., El-karim, I., Duncan, H.F., Krastl, G., & Galler, K.M. (2023). Implications of root, pulp chamber, and canal anatomy on pulpotomy and revitalization procedures. Clinical Oral Investigations, 27(11), 6357-6369. https://dx.doi.org/10.1007/s00784-023-05284-9

MLA:

Ahmed, Hany Mohamed Aly, et al. "Implications of root, pulp chamber, and canal anatomy on pulpotomy and revitalization procedures." Clinical Oral Investigations 27.11 (2023): 6357-6369.

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