Clinician Decision-Making for the Endodontic Treatment of Immature Permanent Teeth: A National Survey of Pediatric Dentists and Endodontists

Background: Evidence suggests that pediatric patients requiring endodontic treatment in the permanent dentition are often a “missed population”. Aim: This study surveyed pediatric dentists and endodontists about the frequency with which they encounter pediatric patients requiring endodontic treatment, their training, practice patterns, and decision-making considerations for the treatment of immature permanent teeth. Design: Surveys were distributed to endodontists (n = 2457) and pediatric dentists (n = 3974) in the United States. Data were analyzed using descriptive statistics and X² analysis. The level of significance was set at 0.05. Results: The response rate was 13.1% (n = 840). The frequency of clinicians encountering pediatric patients requiring endodontic treatment for permanent teeth did not differ significantly by specialty. Pediatric dentists and endodontists reported statistically significant differences in their practice patterns related to the performance of vital pulp therapy (p < 0.001) and procedures for necrotic immature permanent teeth (p < 0.001). Among specialists, apexification was more frequently performed than regenerative endodontic procedures (REPs) (p < 0.001). When asked to consider clinical and patient factors related to the treatment of necrotic immature permanent teeth, pediatric dentists most frequently responded that they were “unsure” of their preferred treatment. Conclusion: Standardized clinical knowledge and management of immature permanent teeth between specialties may improve interdisciplinary care for pediatric patients.