Root Canal Therapy (Non-Surgical Endodontics)
A root canal is one of the most common dental procedures performed with close to 15 million completed each year with a 90% success rate. This simple treatment can save your natural teeth and prevent the need for dental implants or bridges. Beneath the white enamel and another hard layer called dentin, is a soft tissue inside the tooth called pulp. Pulp contains nerves, blood vessels, and other connective tissue. During development the pulp helps the root(s) of your teeth to grow. A tooth that is fully developed is able to survive without the pulp because the surrounding tissues continue to nourish it. Infection of the pulp can be caused by trauma to the tooth, cracks, chips, deep decay, or repeated dental procedures. Symptoms of the infection can vary from visible injury, swelling around the tooth, sensitivity to temperature, or pain in the tooth and gums. During a root canal the inflamed or infected pulp is removed from each root. The inside of the canal is then carefully cleaned and disinfected. A rubber-like material called gutta-percha is then used to fill and seal the canal. After your root canal therapy has been completed a report of your treatment will be sent to your general dentist. You should contact your general dentist's office for follow up restoration within 2 - 4 weeks after completion of root canal therapy in our office. Once the tooth is restored with a permanent filling or a crown, which is recommended to fortify the tooth, the treated tooth will continue to function like any other tooth.
Retreatment
With the appropriate care, your tooth that has had endodontic treatment will last as long as your other untreated teeth. Occasionally a tooth will not heal as expected after its initial treatment. Sometimes retreatment can be necessary if the crown or restoration was not placed within the appropriate time frame. During retreatment, the restorative materials are removed, and the canals are cleaned and carefully examined to see if there is unusual anatomy or additional canals that were not previously treated. After the procedure is completed, a visit as soon as possible with your regular dentist for the final restoration and possible crown placement is needed.
Apicoectomy
Generally, root canal therapy or retreatment is what is needed to save teeth. Occasionally, these nonsurgical procedures will not be sufficient to heal the tooth. In these cases apical surgery (apicoectomy) is recommended. An apicoectomy, or root-end resection, is often used when inflammation or infection persists in the bony area around the end of the tooth or when fractures or hidden canals that do not appear on x-rays are still causing pain in the tooth. During the procedure, the gum tissue is opened over the infected area. The infected tissue is removed as well as the tip (apex) of the affected root. Occasionally, a small filling, called a retrograde filling, may be placed to seal the end of the root. A few sutures are placed in the gum to help it heal properly, and are then removed about a week later.
Root Amputation
A root amputation is similar to an apicoectomy, but the root is cut closer to the neck of the tooth at the furcation (where the roots split at the neck). Depending on the case, a retrograde filling may be placed at that time. Sutures are set in the gum, and removed a week later.
Cracked Teeth
Cracked teeth can demonstrate many types of symptoms, including temperature sensitivities, pain when chewing or the release of biting pressure. The pain is often intermittent, making it difficult to diagnose. There are many different types of cracked teeth and treatment of your tooth depends on the type, location, and extent of the crack. Craze lines are tiny superficial cracks that only affect the outer enamel of the tooth. These cracks are more common in adults and are usually of no concern. A fractured cusp occurs when a cusp becomes weakened and may break off or be removed by a dentist. A fractured cusp rarely damages the pulp, so a root canal is usually not necessary. A treatable cracked tooth starts at the chewing surface and starts to vertically extend towards the root. Damage to the pulp is very common and usually requires root canal therapy. Early detection is vital to saving the tooth as the crack often continues to extend when left untreated. A split tooth is a crack with distinct segments. This type of crack cannot be saved while leaving the tooth completely intact. Sometimes a portion of the tooth can still be saved which would require endodontic retreatment. A vertical root fracture is one that begins at the root and extends towards the chewing surface. They are more asymptomatic and often go undetected. Occasionally, the tooth can be saved by removing the fractured root, but most cases result in the tooth needing extraction.
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