SP-44 - When Is Root Canal Treatment Indicated After Trauma to a Tooth?

Traumatic dental injuries are potentially very complex and can lead to a number of different responses of the pulp and peri-radicular tissues. A thorough understanding of the various potential pulp responses is essential so appropriate management can be undertaken. Following many injuries, the pulp may survive – but this can only occur if the pulp is managed appropriately at the emergency visit which includes not removing the pulp in many cases! However, there are some specific injuries where pulp survival is predictably unlikely. If the pulp necroses and becomes infected, then there is the potential for external inflammatory resorption to develop if there has also been damage to the periodontal ligament and/or external root surface of the tooth. In such situations, a preventive approach can be used to prevent this resorption from developing. A key factor is to recognize which specific injuries make teeth susceptible to this type of resorption. Hence, understanding and knowing when and when not to commence root canal treatment after a traumatic dental injury is essential to ensure better outcomes and prognoses for traumatized teeth. This lecture will review the literature and provide guidelines for practitioners regarding when and when not commence root canal treatment.