Biologiske prinsipp for behandling av umodne permanente tenner med pulpaskade

English summary Biological principles for treatment of immature permanent teeth with pulpal pathosis 190-7. Endodontic therapy of permanent teeth with open apex is a challenging problem. An immature tooth with open apex is rich in stem cells in the pulp and apical papilla facilitating healing and continued root development. Traditional treatment of a tooth with open apex has been calcium hydroxide apexification. A tooth with open apex with localised pulpitis or partial necrosis has the potential to heal after partial pulpotomy with continued root development and dentine wall deposition without the need for apexification procedures. Revascularization or mineral trioxide apexification (MTA) apexification is recommended when the pulp is completely necrotic with or without apical periodontitis. Treatment protocols and the use of new materials such as MTA and triple paste, a combination of three antibiotics, are discussed here. An understanding of pulp biology is the key to long term success when treating teeth with open apex. Treatment has to be aimed at either maintaining the pulp vitality or revascularization of pulp-like tissue in the necrotic pulp canal space.