What is Endodontics?
before treatment
after treatment
regenerated tissue
after six months
Endodontics is the specialty field in dentistry dedicated solely to root canal treatments and related microsurgical procedures. Literally, endo means “inside” and dontics means “tooth.” Endodontists, the practitioners of endodontics, are dentists who have pursued additional training, two or more years, in order to specialize in this field.
What is a Root Canal?
All teeth have a hollow space inside them where nerves and blood vessels reside. When teeth experience decay, cracks, a history of many fillings, trauma, or other sources of stress, bacteria have an opportunity to enter the hollow space of the tooth. Once bacteria or irritants gain entrance to this space, the body cannot get enough blood into the tooth to resolve this condition, and the nerve may begin to degenerate. The tooth becomes painful when this happens. Eventually, bacteria will leak out the tip of the root of the tooth, and an abscess may develop, causing swelling and pain. Root canal therapy is designed to resolve or prevent this situation. The only other treatment alternative to a root canal is extraction of the tooth.
The basic premise of root canal treatment has two parts. First, clean out the hollow space inside the tooth in an attempt to get rid of the invading bacteria, irritants, and damaged nerve. Second, to seal off the cleansed hollow space, in an effort to prevent the return of bacteria or irritants into the area. Usually, both steps may be done during a single appointment; however, more than one appointment may be necessary in certain cases. In order to achieve both these steps, an access hole must be made in the tooth. A temporary filling is placed in the access opening after treatment. After root canal therapy is completed, it is essential that you return to your general dentist for final restoration. A crown is usually the preferred restoration on molars and premolars.
More than 90% of endodontic cases respond to root canal treatment. For cases that do not respond, it does not necessarily mean the tooth is lost. In some unresponsive cases, endodontic surgery or retreatment of the root canal can resolve the problem and allow you to keep your tooth. These procedures are successful and predictable and modern endodontics can now achieve results that were unavailable a decade ago.
Recent Advances in Endodontics
Many advances in endodontics have occurred in the last few years. These include:
- Digital X-rays. X-ray images are essential to the proper completion of root canal therapy. Digital x-rays are x-rays taken directly on a computer without the use of film. This system is uniquely suited to endodontics and provides the benefit of an 80-90% reduction in radiation to the patient.
- Microscopes. The root canal is a very small space, and the implementation of microscopic treatment both in conventional and surgical endodontics has resulted in a large improvement in treatment success. Results for certain cases, which would have been unachievable a few years ago, are now possible through the use of the operating microscope.
- Retreatment Techniques. Sometimes, root canals can become re-infected. Historically, surgery was performed in order to treat this occurrence. Although surgery is still a viable option, the addition of ultrasonic instrumentation and other new techniques have increased the feasibility of re-treatment as an option over surgical intervention.