I am happy to address the questions Dr. Needleman has raised and thank him for his interest in our article.
How was the diagnosis of irreversible pulpitis made? The diagnosis was based on the patients’ symptoms and their response to thermal pulp testing. Typically, a patient would report a history of symptoms and a response to thermal insult that lingered longer than a control. This history and response to thermal insult was diagnosed as irreversible pulpitis. The decision to carry out a pulpotomy procedure as opposed to a pulpectomy was then based on the clinical ability to control hemorrhage.
I assume that the "complicated enamel dentin fractures" all involved pulpal exposure by definition. Is that in fact the case? Correct. This categorization is based on the one that Andreasen and Andreasen1 use in their text. What was the time intervals between the traumatic pulpal exposures and treatment? All patients where seen on a delayed basis, ranging from four to 24 hours after the initial injury. Most patients were seen 12 to 24 hours postinjury.
What was the maturity of the apexes of these teeth? Seven of your 23 cases were IP/T/CEDF and all but one of the seven were 9 years old or younger, so I assume the apexes were not fully closed. Correct. In the patients younger than 9 years, the apexes were not fully closed.
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