Endodontics therapies

Endodontic Procedures

Endodontic treatment can often be performed in 1-3 visits and involves the following steps:

1. The endodontist examines and x-rays the tooth, then administers local anesthetic. After the tooth is numb, the endodontist places a small protective sheet called a "dental dam" over the area to isolate the tooth and keep it clean and free of saliva during the procedure.

2. The endodontist makes an opening in the crown of the tooth. Very small instruments are used to clean and shape the pulp chamber and root canals, to prepare the canals for filling.

 
What are the alternatives to endodontic surgery?

Often, the only alternative to surgery 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 alternatives require surgery or dental procedures on adjacent healthy teeth, endodontic surgery is usually the most cost-effective option for imagestaining your oral health. No matter how effective modern tooth replacements are - and they can be very effective - nothing is as good as a natural tooth. You've already made the investment in saving your tooth. The pay-off for choosing endodontic surgery could be a healthy, functioning natural tooth for the rest of your life.

Cracked tooth

Why does a cracked tooth hurt? To understand why a cracked tooth hurts, 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 the inner soft tissue called the pulp. The pulp contains blood vessels, nerves, and connective tissue.

When the outer hard tissues of the tooth are cracked, the chewing can cause movement of the pieces, and the pulp can become irritated. When biting pressure is released, the crack can close quickly, resulting in a momentary, sharp pain. Irritation of the dental pulp can be repeated many times by chewing. Eventually, the pulp will become damaged to the point that it can no longer heal itself. The tooth will not only hurt when chewing but may also become sensitive to temperature extremes. In time, a cracked tooth may begin to hurt all by itself. Extensive cracks can lead to infection of the pulp tissue, which can spread to the bone and gum tissue surrounding the tooth.

Types of Cracks

There are many different types of cracked teeth. The treatment and outcome for your tooth depends on the type, location, and severity of the crack. Craze Lines Craze lines are tiny cracks that affect only the outer enamel. These cracks are extremely common in adult teeth. Craze lines are very shallow, cause no pain, and are of no concern beyond appearances.

Fractured Cusp

When a cusp (the pointed part of the chewing surface) becomes weakened, a fracture sometimes results. The weakened cusp may break off by itself or may have to be removed by the dentist. When this happens, the pain will usually be relieved. A fractured cusp rarely damages the pulp, so root canal treatment is seldom needed. The tooth will usually be restored by your dentist with a full crown.

Split Tooth

A split tooth is often the result of the long term progression of a cracked tooth. The split tooth is identified by a crack with distinct segments that can be separated. A split tooth can never be saved intact. The position and extent of the crack, however, will determine whether any portion of the tooth can be saved. In rare instances, endodontic treatment and a crown or other restoration by your dentist may be used to save a portion of the tooth.

Vertical Root Fracture

Vertical root fractures are cracks that begin in the root of the tooth and extend toward the chewing surface. They often show minimal signs and symptoms and may therefore go unnoticed for some time. Vertical root fractures are often discovered when the surrounding bone and gum become infected. Treatment usually involves extraction of the tooth. However, endodontic surgery is sometimes appropriate if a portion of the tooth can be saved by removal of the fractures root.

Will my tooth completely heal? Unlike a broken bone, the fracture in a cracked tooth will never heal. In spite of treatment, some cracks may continue to progress and separate, resulting in loss of the tooth. Placement of a crown on a cracked tooth provides maximum protection but does not guarantee success in all cases.

The treatment you receive for your cracked tooth is important because it will relieve pain and reduce the likelihood that the crack will worsen. Once treated, most cracked teeth continue to function and provide years of comfortable chewing. Talk to your dentist and/or endodontist about your particular diagnosis and treatment recommendations. They will advise you on how to keep your natural teeth and achieve optimum dental health.

Retreatment

A second chance to save your tooth. With proper care, most teeth that have had endodontic (root canal) treatment can last as long as other natural teeth. In some cases, however, a tooth that has received endodontic treatment fails to heal or the pain continues. Occasionally the tooth becomes painful or diseased months or even years after successful treatment. If your tooth has failed to heal or has developed new problems, you have a second chance. Another endodontic procedure may be able to save your tooth.

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.

1. Narrow or curved canals were not treated during the initial procedure.

2. Complicated canal anatomy went undetected in the first procedure.

3. The crown or other restoration was not placed soon enough after the procedure.

4. The restoration did not prevent saliva from contaminating the inside of the tooth.

   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 non-surgical treatment. In such a case, surgery allows your endodontist to examine the root of your tooth, find the problem, and provide treatment.

Sometimes calcium deposits make a canal too narrow for the cleaning and shaping instruments used in non-surgical root canal treatment to reach the end of the root. If your tooth has this "calcification," your endodontist may perform surgery to clean and seal the reimagesder 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 fail to heal. The 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.

What is an apicoectomy?

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. 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 also be placed to seal the end of the oral canal, and a few stitches or sutures are placed in the gum to help the tissue heal properly. Over a period of months, the bone heals around the end of the root.

Are there any other types of endodontic surgery?

Other surgeries endodontists might perform include dividing a tooth in half, repairing an injured root, or even removing one or more roots. Your endodontist will be happy to discuss the specific type of surgery your tooth requires. In very complex cases, a procedure called intentional replantation may be performed. In this procedure, a tooth is extracted, treated with an endodontic procedure while it is out of the mouth, and then replaced in its socket. The procedures are designed to help you save your tooth.

Will the procedure hurt?

Local anesthetics make the procedure comfortable. Of course, you may feel some discomfort or experience slight swelling while the incision heals. This is normal for any surgical procedure. Your endodontist will recommend appropriate pain medication to alleviate your discomfort. Your endodontist will give you specific postoperative instructions to follow. If you have questions after your procedure, or if you have pain that does not respond to medication, call your endodontist.

Can I drive myself home?

Often you can, but you should ask your endodontist before your appointment so that you can make transportation arrangements if necessary.

When can I return to my normal activities?

Most patients return to work or other routine activities the next day. Your endodontist will be happy to discuss your expected recovery time with you.

How do I know the surgery will be successful?

Your dentist or endodontist is suggesting endodontic surgery because he or she believes it is the best option for you. Of course, there are no guarantees with any surgical procedure. Your endodontist will discuss your chances for success so that you can make an informed decision.

dental professionals-Why the team approach?

After endodontic care a tooth will require a final restoration. This can involve a permanent filling and often times a full coverage crown. Huszti Dental Care has been a mainstay in the Milford and Highland areas and are well versed in the treatment options of choice following root canal therapy. Huszti dental care is a valuable partner with expertise in restorative treatments including : Dental implants, family dentistry and cosmetic dentistry.