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Revascularization Study

Page One

Thank you for agreeing to submit information related to your revascularization cases. The data gathered here will be used in endodontic research. This information will help to establish “best practice” for treatment of and future research on the incompletely developed tooth with a necrotic pulp.

Please enter information on both successful and unsuccessful cases. In all cases provide as much information as you can.

Enter one case (one tooth) at a time. At the end of this form you will be asked whether you would like to enter another case. Your answer will terminate your session or send you back to the beginning for entering a new case, as appropriate. You may bookmark this form and return to it later but be sure to only exit after clicking “Next” otherwise the current pages responses will be lost. Each case should require about 10-15 minutes to enter. Please have appointment records and radiographs readily available while entering the case information.

Note: Due to page logic do not use your browser's "Back" button. If you need to edit information already entered, contact Dr. Ed Halteman,