Treatment Information

Conventional Non-surgical Root Canal Treatment

Non-surgical root canal treatment can be performed in one visit 99% of the time.

Step One:

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.

Step Two:

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

Step Three:

After the space is cleaned and shaped, the endodontist fills the root canals with a biocompatible material, called “gutta percha.” The gutta percha is placed with an adhesive cement to endure complete sealing of the root canal system. In most cases, a temporary filling is placed to close the opening. Your general dentist will remove the temporary filling before the tooth is permanently restored.

Step Four:

After the final visit with your endodontist, you must return to your dentist to have a crown or other restoration placed on the tooth to protect and restore it to full function.

Lack of Tooth Structure Remaining:

If the tooth lacks sufficient tooth structure to hold the restoration in place, your dentist or endodontist may place a post inside the tooth. Ask your dentist or endodontist for more details about the specific restoration planned for your tooth.

Endodontic Re-Treatments

With appropriate care, the teeth that have had endodontic treatment by a well trained clinician will last as long as other natural teeth. Yet a tooth that has received treatment may fail to heal or pain may continue to exist. Sometimes the pain may occur months or years after treatment. If so, endodontic retreatment may be needed.

Improper healing, necessitating an endodontic retreatment, may occur if:

1. Curved or narrow canals were not treated during the initial treatment;

2. Complicated canals went undetected during the initial treatment;

3. The crown was not placed within the appropriate amount of time following the root canal procedure;

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

Micro-Surgical Root Canal Treatment

Generally, a non-surgical root canal is all that isneeded to save teeth with injured pulp fromextraction. Occasionally, this non-surgicalprocedure will not be sufficient to heal the toothand your endodontist will recommend surgery. Endodontic surgery can be used to locate fracturesor hidden canals that do not appear on x-rays butstill manifest pain in the tooth. Damaged rootsurfaces or the surrounding bone may also betreated with this procedure. The most commonsurgery performed to save damaged teeth is anapicoectomy or root-end resection. The diagramsbelow illustrate this simple procedure. An incisionis made in the gum tissue to expose the bone andsurrounding inflamed tissue. The damaged tissue is removed along with the end of the root tip. A root-end filling is placed to prevent re-infection of the root and the gum is sutured.

A small filling is placed to seal the end ofthe root canal and a few stitches or sutures areplaced in the gum to help the tissue heal properly.

Over a period of months, the bone heals aroundthe end of the root.

Marc Bowers DMD PA 2020