Root Canal Treatment

Root Canal Treatment

Root Canal Treatment (Endodontic Treatment) is the diagnosis and treatment of diseases of the dental pulp.  The dental pulp consists of nerves, blood vessels, and lymphatics.  Root Canal Treatment is indicated when the pulp becomes inflamed or infected.  This can be caused by any of the following:

• Deep Decay
• Repeated dental procedures on the tooth or surrounding structures
• Trauma to the area (i.e. car accidents, blows to the face)
• A crack, fracture, or chipped tooth.

Root Canal Treatment - The Procedure

Root Canal Treatment can be accomplished in as few as one visit and up to several visits. Once a diagnosis has been made with the use of a health history, x-rays, and clinical findings treatment may begin.

1. The patient is numbed with a local anesthetic and a protective rubber dam (‘dental dam’) is placed over the tooth to protect the patient and keep the working area dry and free from saliva.
2. A conservative opening is made in the crown of the tooth. Small files are used to remove the infected pulp and to clean and shape the canal system. It is important to note that the dental pulp is being removed, not the root itself.
3. Once the root canal(s) are cleaned, a biocompatible (usually gutta percha) filling material is placed to the apex of the canal.
4. After the root canal is completed, the patient returns to his/her dentist for a proper restoration. After approximately 6 months the surrounding bone should be reformed.

Endodontic Retreatment

In certain instances, as with any other medical or dental surgeries, a tooth may not heal properly after the root canal has been completed. This can happen for a number of reasons:

• Curvy or narrow roots were not cleaned during the initial treatment
• Canals may be blocked (calcified) not allowing the entire canal to be cleaned
• A restoration was not placed at all or soon enough after the initial treatment
• The restoration failed, allowing saliva to contaminate the inner anatomy of the tooth
• New decay developed

1. The old filling material is removed.
2. The canal is reworked and cleaned.
3. New filling material is placed.

Endodontic Surgery

In certain instances endodontic surgery is performed. This can be due to a variety of situations:

• If blocked or calcified canals could not be instrumented during initial or retreatment. Endodontic surgery may be used to clean the rest of the canal.
• Surgery may be used to diagnosis a persistent problem. If a tooth is symptomatic after initial treatment or retreatment and no problems appear on the x-ray, then a small fracture may be present that may not be detectable by non-surgical procedures.

1. A tiny incision is made near the site of infection. The infected tissue is removed.
2. A filling is placed in the end of the root. Sometimes a synthetic bone graft is placed to aid in the healing of surrounding bone.
3. The incision site is sutured.