The management of non-vital immature permanent incisors

The management of pulp necrosis in an immature permanent incisor can pose a significant challenge with regards to both the techniques and behaviour management. The aim of this paper is to outline the commonly described techniques in the endodontic management of the immature incisor, although it is appreciated that readers may have varying experience of these techniques and that in some cases these may be more appropriately completed in specialist centres.

The completion of root development of the permanent incisors normally occurs in childhood, eg the maxillary central incisor normally completes its root development before the age of around 10 or 11 years-old.2 Patients with non-vital immature incisors will therefore tend to be of a young age, which may pose challenges relating to their ability to co-operate for the required treatment. Although further discussion regarding behaviour management of the child patient is outwith the scope of this article, it is worth bearing in mind that management of the immature incisor may require multiple treatment visits over a prolonged period of time, precluding the use of general anaesthesia, and therefore highlighting the need for alternative behaviour management strategies.