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Endodontic Treatment
What is Endodontist?
The Endodontist is a root canal specialist
With the lengthy education that an endodontist receives, they are able to perform
all aspects of root canal therapy including routine as well as complex root canals,
retreatments and endodontic surgery.
What
is endodontic treatment?
“Endo” is the Greek word for “inside” and “odont” is Greek for “tooth.” Endodontic
treatment treats the inside of the tooth. Root canal treatment is one type of
endodontic treatment.
To understand endodontic treatment, it helps to know something about the anatomy
of the tooth. Inside the tooth, under the white enamel and a hard layer called
the dentin, is a soft tissue called the pulp. The pulp contains blood vessels,
nerves, and connective tissue and creates the surrounding hard tissues of the
tooth during development.
The pulp extends from the crown of the tooth to the tip of the roots where it
connects to the tissues surrounding the root. The pulp is important during a tooth’s
growth and development. However, once a tooth is fully mature it can survive without
the pulp, because the tooth continues to be nourished by the tissues surrounding
it.
Endodontic Retreatment
Why do I need another endodontic procedure?
As occasionally happens with any dental or medical procedure, a tooth may not
heal as expected after initial treatment for a variety of reasons:
Narrow or curved canals were not treated during the initial procedure.
Complicated canal anatomy went undetected in the first procedure.
The placement of the crown or other restoration was delayed following the endodontic
treatment.
The restoration did not prevent salivary contamination to the inside of the tooth.
In other cases, a new problem can jeopardize a tooth that was successfully treated.
For example:
New decay can expose the root canal filling material to bacteria, causing a new
infection in the tooth.
A loose, cracked or broken crown or filling can expose the tooth to new infection.
A tooth sustains a fracture.
What will happen during retreatment?
First, the endodontist will discuss your treatment options. If you and your endodontist
choose retreatment, the endodontist will reopen your tooth to gain access to the
root canal filling material. In many cases, complex restorative materials-crown,
post and core material-must be disassembled and removed to permit access to the
root canals.
After removing the canal filling, the endodontist can clean the canals and carefully
examine the inside of your tooth using magnification and illumination, searching
for any additional canals or unusual anatomy that requires treatment.
After cleaning the canals, the endodontist will fill and seal the canals and place
a temporary filling in the tooth. If the canals are unusually narrow or blocked,
your endodontist may recommend endodontic surgery. This surgery involves making
an incision to allow the other end of the root to be sealed.
After your endodontist completes retreatment, you will need to return to your
dentist as soon as possible to have a new crown or other restoration placed on
the tooth to protect and restore it to its full function.
Is retreatment the best choice for me?
Whenever possible, it is best to save your natural tooth. Retreated teeth can
function well for years, even for a lifetime.
Advances in technology are constantly changing the way root canal treatment is
performed, so your endodontist may use new techniques that were not available
when you had your first procedure. Your endodontist may be able to resolve your
problem with retreatment.
As with any dental or medical procedure, there are no guarantees. Your endodontist
will discuss your options and the chances of success before beginning retreatment.
What are the alternatives to retreatment?
If nonsurgical retreatment is not an option, then endodontic surgery should be
considered. This surgery involves making an incision to allow access to the tip
of the root. Endodontic surgery may also be recommended in conjunction with retreatment
or as an alternative. Your endodontist will discuss your options and recommend
appropriate treatment.
What are the alternatives to endodontic retreatment
and/or endodontic surgery?
The only other alternative is extraction of the tooth. The extracted tooth must
then be replaced with an implant, bridge or removable partial denture to restore
chewing function and to prevent adjacent teeth from shifting. Because these options
require extensive surgery or dental procedures on adjacent healthy teeth, they
can be far more costly and time consuming than retreatment and restoration of
the natural tooth.
No matter how effective tooth replacements are-nothing is as good as your own
natural tooth. You’ve already made an investment in saving your tooth. The payoff
for choosing retreatment could be a healthy, functioning natural tooth for many
years to come.
Endodontic Surgery
Why would I need endodontic surgery?
Surgery can help save your tooth in a variety of situations. Surgery may be used
in diagnosis. If you have persistent symptoms but no problems appear on your x-ray,
your tooth may have a tiny fracture or canal that could not be detected during
nonsurgical treatment. In such a case, surgery allows your endodontist to examine
the entire root of your tooth, find the problem, and provide treatment.
Sometimes calcium deposits make a canal too narrow for the instruments used in
nonsurgical root canal treatment to reach the end of the root. If your tooth has
this “calcification,” your endodontist may perform endodontic surgery to clean
and seal the remainder of the canal.
Usually, a tooth that has undergone a root canal can last the rest of your life
and never need further endodontic treatment. However, in a few cases, a tooth
may not heal or become infected. A tooth may become painful or diseased months
or even years after successful treatment. If this is true for you, surgery may
help save your tooth.
Surgery may also be performed to treat damaged root surfaces or surrounding bone.Although
there are many surgical procedures that can be performed to save a tooth, the
most common is called apicoectomy or root-end resection. When inflammation or
infection persists in the bony area around the end of your tooth after a root
canal procedure, your endodontist may have to perform an apicoectomy.
What is an apicoectomy?
In this procedure, the endodontist opens the gum tissue near the tooth to see
the underlying bone and to remove any inflamed or infected tissue. The very end
of the root is also removed. A small filling may be placed in the root to seal
the end of the root canal, and a few stitches or sutures are placed in the gingiva
to help the tissue heal properly.Over a period of months, the bone heals around
the end of the root.
