Types of Endodontics
There are three main treatments within the field of endodontics: 1) Endodontics (root canal and dental pulp procedures), 2) Endodontic Retreatment, 3) Periapical surgery (apicoectomy)
1. Endodontics (root canal)
The first kind of treatment to correct irreversible swelling or necrosis (death) of dental pulp (dental nerve). This treatment consists of eliminating the content of the nerve canals, which can consist of bacteria or pulp.
After step A, there is a procedure to clean, disinfect, shape, and seal the canals with a sterile sealing material called gutapercha. This is done in order to allow the healing of the surrounding tissue of the root.
2. Endodontic Retreatment
If the tooth has already received an endodontic treatment but the symptoms persist, an endodontic retreatment should be considered. During this procedure the sealing agent that was introduced in the canals during a previous treatment needs to be removed. This will allow for further sterilization and shaping for further filling.
In some cases, it is necessary to introduce medication between appointments to help eliminate bacteria. In most cases, retreatment can correct the failing of the previous endodontic treatment (omitted canals that were not treated or mistreated). However, it is possible that even after the intervention the symptoms will persist and as a result, surgical treatment is required.
3. Periapical surgery (apicoectomy)
Surgery is needed if the following conditions are observed after conducting endodontic retreatment
1. Presence of a lesion on the root apex
2. Persistence of symptoms
3. When another retreatment cannot be performed
a. Complex anatomy
b. Canal obstruction (crowned teeth)
Instead of entering through the crown of the tooth, periapical surgery goes straight to the lesion through the bone in the periphery of the roots. During this procedure, the lesion is eliminated and a small fraction of the root is removed and sealed.
Frequently Asked Questions
-It is a treatment in which the nerve of the tooth is removed. Afterwards the remaining canal will be cleaned, disinfected, and shaped. Once we are satisfied with the condition of the canal, sterile sealant is applied to fill the canal in order to avoid future infections.
-Dental Caries (cavities )
-Cumulative effect of dental procedures (fillings, crown preparations)
-Pre-prosthetic reasons (when a tooth is going to be crowned)
On average, due to my extensive experience and state of the art equipment, root canals are completed during a one-hour visit. In some cases when there is presence of infection and abscess, two appointments are needed in order to apply medication to resolve the infection.
The procedure itself is not painful due to the fact that we use localized anesthesia to numb the area. After the treatment is completed, it is normal to feel soreness. This is within the normal parameters given that the tissue around the tooth (bone, and periodontal ligament) can become inflamed. In a matter of days, this soreness will disappear.
If the right treatment is offered, teeth with endodontic treatment can last a lifetime. The fact that a tooth has been treated for endodontics does not prevent it from developing future cavities. Therefore, a tooth that has received root canal should be cared for in the same manner as any other tooth.