The American Dental Association defines endodontics as a specialty that treats the tooth, dental pulp, and surrounding tissues.
We all recognize the hard, white crown of the tooth but there is a lot of tooth under the gumline. This is the root. It has a hard outer shell called dentin. Inside is the root canal, which contains soft pulp made of blood vessels, nerves, and connective tissue.
The pulp extends from the tip of the root high up into the crown, and it’s essential for tooth growth, development, and health. After the tooth finishes growing, the pulp can be removed as the surrounding tissue continues to nourish it.
The pulp can suffer damage without visible harm to the crown. Gum disease, tooth decay, or fractures can let bacteria in, causing pain and swelling. A successfully treated tooth can function normally, but without root canal treatment, damaged pulp can cause tooth loss.
Root canal procedures become necessary when a tooth’s pulp becomes inflamed or infected. Often this is caused by a large cavity, tooth trauma, or significant tooth restoration. Sharp pain, heat or cold sensitivity, color alteration, or gum swelling and discomfort are common signs of pulp damage, which must be treated to save the tooth.
While pulp problems are serious, their treatment is generally completed without surgery. The injured pulp is extracted through the upper tooth surface. After the infected tissue is cleared, the endodontist cleans the root canal and removes all infected material and bacteria from its surface. Finally, a sterile substance is used to seal the root canal system, guarding against reinfection.
After a root canal procedure, you’ll need to visit a restorative dentist for a permanent filling or crown.
Occasionally, reinfection makes “retreatment ” or “revision” of a root canal treatment necessary. These rare cases are caused by incomplete earlier root canal therapy, unusual canal anatomy, or contamination of a leaking restoration.
Our experienced team can often successfully retreat your tooth and surrounding tissues.
After an examination involving 2D digital and 3D computed tomography, we’ll go over your treatment options with you. Usually, we’ll remove the failed root canal materials, then clean the canals using a specialized microscope and digital imaging to ensure the best results. Finally, we reseal the root canal system with new sterile material.
Postoperative procedures are similar to regular root canal treatments, but success rates for revisions or retreatments are slightly lower.
Very rarely, root canal therapy doesn’t cure the infection, leading to a revision of the procedure. If the infection remains after the revision, surgical removal of the infected root tip(s) or apex and the surrounding tissue, then a process is known as apical microsurgery, or apicoectomy, may be needed.
Before the procedure, a thorough examination and diagnosis are necessary. The surgery starts with a local anesthetic, after which an incision allows the endodontist access to the infected area. A surgical operating microscope with special coaxial lighting is used for the procedure. After the infected area is clean, the root tip is sealed using a biocompatible substance. The site is closed by dissolvable sutures.
Swelling is minor in most cases. Medication will help and enable you to return home. We’ll carefully monitor the healing process as new bone forms around the root end. Your safety and comfort are our top priority at Russo Endodontics.