Prevention of Dental Diseases and Modern Clinical Diagnosis Methods

Abstract

In the treatment of pulpitis of permanent teeth with unformed roots in children, the dentist primarily relies on knowledge of the morphological structure of their root system. Therefore, currently, when choosing the tactics of endodontic treatment of such children, preference is given to classical methods, in particular, vital amputation. During the last procedure, the infected coronal part of the pulp is necrotized, while the root part remains intact and is covered with a medicinal agent. This is necessary for the successful completion of apexification, that is, the closure of the root apex at the developmental stage. There is a wide range of drugs to stimulate apexification when performing vital amputation. The most effective of them are preparations based on calcium hydroxide, mineral trioxide aggregate (MTA) and paraformaldehyde. However, clinical experience shows that these drugs are not without significant drawbacks, the main one being dehydration of the root dentin, which contributes to increased root fragility and, as a result, an increased risk of tooth root fracture. In addition, treatment with calcium-based drugs is long-term and requires a large number of visits. To overcome these shortcomings, the American Association of Endodontics has proposed an alternative method - revascularization (regenerative endodontic treatment) based on irritation of the periapical tissues by intensive instrumental treatment of the root canals to stimulate bleeding and the formation of blood clots containing stem cells and growth factors that contribute to the closure of the apices. In this regard, this literature review describes clinical studies of recent years, including a comparative analysis of the most common drugs used in the treatment of pulpitis in teeth with unformed roots by the method of vital amputation, as well as recent prospective studies, including the results of clinical application of the revascularization method.