A root canal (also called root canal treatment or root canal therapy) is a non-surgical procedure to remove a damaged pulp (soft-tissue core) of the tooth in order to preserve natural function. To learn more about root canal treatment, click on the image below.
Depending on the type and condition of the tooth, a crown may be needed to protect your root canal treated tooth from fracture. Your family dentist will prepare and make the crown if it is needed.
Root Canal Retreatment
Most teeth respond to root canal therapy. In some cases the root canal may need to be retreated due to residual infection that was resistant to the first root canal or salivary contamination (leakage) around a crown or filling that has re-infected the tooth. A retreatment is a non-surgical procedure to remove the existing root canal filling material, re-soak, disinfect and refill the canals to try to save the tooth from extraction. It can be done by accessing through the biting surface of the tooth (or accessing through an existing crown). Field Endodontics incorporates specialized equipment and techniques to perform root canal treatment and retreatment including the use of an operating microscope.
Surgical Root Canal Treatment
When a tooth has been damaged by infection, trauma or fracture to the extent that a non-surgical root canal alone cannot correct the problem, sometimes a surgical root canal procedure is decided upon. This involves making an incision in the gum tissue and accessing the problem area from this surgical approach. This type of surgery usually occurs after a non-surgical root canal has been attempted and didn't resolve the problem entirely. Usually, the need for surgery is due to aggressive or advanced oral infections or because of limited available access through the canals themselves.
The most common type of root canal surgery is called an apicoectomy. In this procedure, surgical access is made through the gums, the tip of the root is removed, the tissues around the tooth are treated and the root is sealed. Sutures are then placed in the gum tissue. This promotes healing of the surrounding oral tissues so that the tooth has a better chance to heal instead of needing to be extracted. State-of-the-art techniques are used including microscopic visualization.
Another type of surgical procedure is an incision and drainage (I&D). This is usually performed when a patient has an oral abscess. An I&D is done in conjunction with antibiotic therapy merely to decrease the volume under the tissues that produces swelling and to establish a pathway for drainage. This is performed to aid in decreasing pain and healing time as compared to antibiotic therapy alone. An I&D is rarely the definitive treatment for an oral abscess but instead is an adjunctive procedure in some emergency situations.
Traumatically injured teeth
When a tooth has experienced a dramatic force (bicycle injury, sports injury, car accident, etc.), a specific treatment protocol should be followed. Longevity of healthy natural teeth is always the goal but some traumatically injured teeth cannot be saved. Appropriate protocols vary depending on the classification of the traumatic injury. Endodontic evaluation, treatment and follow-up care are imperative in achieving the best possible long term result. Field Endodontics works in tandem with other dentists and dental specialists in an inter-disciplinary format by evaluating and, if necessary, endodontically treating traumatically injured teeth.
When a tooth has pain and/or infection, sometimes this is due to a crack. Jaw forces are strong and in conjunction with some hard foods or grinding habits tooth enamel can fracture. These cracks are difficult to diagnose and treat due to the unpredictable and sporadic signs and symptoms they cause. Most of the time, fractures cannot be seen radiographically which adds to the diagnostic difficulties. If a tooth has a fracture that has extended onto the root surface, the prognosis of the tooth decreases significantly. Therefore, fracture detection is important at the earliest stage possible. Field Endodontics uses specialized equipment and techniques to aid in detecting fractures.
Vital Pulp Therapy
Sometimes pulp tissue (soft tissue in the hollow core of the tooth) can be treated without full root canal therapy to try to retain as much living tissue inside the tooth as possible. This is limited to cases in which tooth damage is minimal. Some types of vital pulp therapy include: pulpotomy, apexogenesis, indirect pulp cap and direct pulp cap.
When an immature tooth has been traumatized or has infection and needs full endodontic therapy, successful treatment is more difficult due to the fragile root structure that didn't have the chance to completely develop. Even though the prognosis is usually decreased in these cases, retaining the teeth as long as possible is preferred, especially in children under the age of 18 since implant therapy is not indicated. In this situation a specific procedure is performed called an apexification to try to establish an apical barrier.