• Root Canal
• Root Canal Retreatment
• Root Resection
• Intentional Reimplantation
• Pulpal Revascularization
Root Canal -The most commonly performed treatment in our office, this procedure is relied upon to replace the nerves and blood supply from the internal aspect of the tooth with a rubber seal while preserving the roots and crown so that the tooth may be retained and relied upon for further function and esthetics. It is often used when the nerves and blood supply within the tooth have become inflamed or infected which can be accompanied by pain or swelling. Sometimes teeth without symptoms are still at a high risk of becoming inflamed or infected and may benefit from root canal treatment if saving the tooth is desired. This procedure is aided by our extensive training and experience in conjunction with the best technology available including dental microscopes, digital x-rays, 3-D scans, electronic devices that can accurately measure the length of the roots and instruments that can conservatively yet effectively clean the inside of the tooth. These skills and techniques allow us to be able to treat teeth with a high rate of predictability and minimal pain or complications.
Root Canal Retreatment - Occasionally a tooth that was treated months or years ago may develop new problems. In some cases a tooth that has received endodontic treatment fails to heal or continues to have pain or signs of infection. In this situation you may consider redoing the root canal. This is called retreatment or a retreat. In this procedure the root canal filling material placed at the time of the original procedure is removed and the root canal system is judiciously recleaned as well as evaluated for additional areas to clean in order to create an environment within the tooth that allows for it to heal and be healthy again. By nature, retreatments have a slightly lower success rate than first treatments.
Apicoectomy - Surgical Endodontics - While root canal therapy is considered a very reliable procedure, it isn’t perfect and sometimes in order for the tooth to heal and be retained, a surgical approach is needed. Usually this is referring to an apicoectomy which is directly removing the tip of one or more roots of a tooth and then placing a seal in the end of the cleaned and shorter root. This procedure, like root canal therapy is performed using the microscope. Looking directly at the root end often reveals reasons for a tooth to have problems that would otherwise not be able to be seen even using x-rays and 3-D scans such as cracks or additional anatomy that would not be able to be cleaned using root canal therapy.
Root Resection - Some teeth have more than one root. Molars have two, three, and sometimes four roots. Premolars have two and occasionally three roots. Usually all roots are treated. Occasionally if one root is not savable, rather than having the whole tooth removed, the “bad” root is removed and the rest of the tooth saved. This is referred to as a root resection or a root amputation. Such a procedure is not always appropriate. Your general dentist along with your endodontists will decide if it is.
Intentional Reimplantation - When a root canal treatment or apicoectomy is not possible on a tooth due to poor access or risks to the surrounding tissues, that tooth is often extracted. However, in some situations, losing that tooth can be avoided. The tooth is instead extracted from its place in the mouth, treated, and then repositioned back in its original position minutes later. This procedure is like an apicoectomy performed outside of the mouth. This is done under sterile, controlled conditions. While this cannot be done in all cases it can be a viable alternative to losing a tooth with a good success rate. Your endodontist will discuss your particular case so that you can make an informed decision about the options and possibilities for your treatment.
Pulpal Revascularization - When a child’s adult teeth erupt they may look like big adult teeth but their root structure is actually still very thin and still forming. If these teeth become infected and the tissue within them dies, the roots cease to form leaving a fragile tooth that is still in need of treatment of the infection. In the past these teeth were treated with conventional root canal therapy where the inside of the tooth was cleaned and sealed. Now, researchers have shown that these teeth may be induced to continue to grow, making for a tooth that presumably will have a better chance of lasting for the patient. This procedure is similar to a root canal but the space within the canal isn’t sealed entirely to the end of the root, instead the endodontist induces a clot to form there that contains cells capable of thickening the immature roots.