Root Canal Treatments for Children
What Is Paediatric Pulpectomy?
Root-canal treatment for children, or pulpectomy, removes necrotic or infected pulp tissue completely, cleans the canal system and seals it with an appropriate filling material.
It is a more advanced step than pulpotomy and is assessed when infection has spread into the root canal. Primary-tooth and young permanent-tooth protocols are not the same.
Primary-tooth Protocol
In primary molars and incisors, canal filling is often done with zinc oxide-eugenol, iodoform or calcium-hydroxide based pastes. Compatibility with physiological resorption is important.
Panoramic or periapical radiographs show root morphology and the level of resorption. Apical resorption may be part of the normal process in primary teeth.
Young Permanent-tooth Protocol
If a permanent tooth with an immature apex has necrosis or apical pathology, apexification or regenerative protocols may be considered after canal disinfection.
When the apex has closed, obturation approaches adult protocols. Vital limited pulp lesions are considered separately with pulpotomy or other conservative approaches.
Clinical Difference from Pulpotomy
Pulpotomy is used only in vital teeth and at the coronal-pulp level; root canals are not shaped and filled as in pulpectomy.
Necrotic pulp, apical radiolucency or abscess may indicate pulpectomy. Failed pulpotomy may later require pulpectomy, but the initial plans are different.
Healing and Alternatives
Radiographic healing in teeth with periapical lesions is followed over months. Abscess, mobility or a fracture that cannot be restored may lead to extraction and space-maintainer assessment.
Restoration is often supported with a stainless-steel crown. The number of visits depends on infection severity, age and cooperation.
In a young permanent tooth, periodic radiographic follow-up may be advised until root development is complete. Abscess and mobility findings can affect the extraction decision; occlusion and contact points are checked after restoration.