Root Canal Therapy

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In the past, if you had a tooth with a diseased nerve, you’d probably lose that tooth. Today, with a special dental procedure called root canal treatment, you may save that tooth. The doctors at The Geller Dental Group utilize digital technology (Root ZX System) to perform root canal therapy. This equipment increases accuracy, reduces chair time, minimizes X-ray exposure and reduces postoperative discomfort. Most of the time a root canal is a relatively simple procedure with little or no discomfort. Best of all, it can save your tooth and your smile!

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Why you need a Root Canal

why root canal therapyAll teeth have three main layers: the outer enamel layer on the top of the tooth or the cementum layer on the root, the inner dentin layer and the pulp. The pulp is the innermost layer within the roots of the tooth containing the nerves and blood vessels that supply the tooth. The blood vessels provide nutrients to the tooth, the nerves provide sensation. When the pulp is intact, the tooth is vital and healthy.

why root canal therapyWhen a tooth becomes decayed or fractured, the bacteria eat their way through the enamel and dentin layers until they reach the pulp tissue. Once here, they cause the pulp tissue to break down, causing destruction of the nerves and blood vessels within the pulp. As the tissue breaks down, an infectious process starts within the pulp and eventually the nerves and blood vessels die. Pressure
from this infectious process builds up within the tooth, usually causing pain, and eventually an abscess develops at the root tip. Until this degraded tissue is removed from within the tooth, this painful infectious process continues.

Cross Section of an Infected Tooth

Cross Section of an Infected Tooth

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Root Canal Procedure

  • root canal procedure
    In a healthy tooth, the innermost pulp layer containing the nerves and blood vessels for the tooth is intact. This pulp tissue keeps the tooth vital.
  • root canal procedure
    Dental decay can cause the pulp tissue to die, creating toxic byproducts. An infectious process begins causing pain and pressure within the root, and eventually an abscess forms.
  • root canal procedure
    When root canal treatment is performed, an opening is created through the top of the tooth to gain access to the pulp. The decayed tissue and infectious debris is cleaned out of the canals using small files.
  • root canal procedure
    Once the canals have been thoroughly cleaned and are free of bacteria, they are sealed with a filling material and usually the abscess will heal. A temporary filling is used to close the opening in the tooth until the final restoration is placed.

Root Canal Procedure – Central Incisor

Root Canal Procedure – Central Incisor

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Root Canal Retreatment

root canal retreatmentRoot canal treatment is performed on teeth where the nerve tissue within the roots has deteriorated, creating an infection. Within the roots are tiny canals where the nerve is located. When the nerve tissue degenerates, these tiny canals must be located, thoroughly cleaned and then sealed with a filling material. In some cases, the canals cannot be located or are constricted, preventing them from being fully cleaned and filled. In this example, the molar tooth has had root canal treatment. One of the canals has not been filled to the root tip,leaving a space in the canal which can become infected again.

root canal retreatmentA second attempt was made on this molar tooth to try to seal the canal all the way to the root tip. The first filling within the root canal was removed and the canal was located, cleaned and refilled, all the way to the tip of the root. In this specific situation,the retreatment was successful, however in some cases, the second result is the same as the first.

When the canals within the root cannot be thoroughly cleaned and sealed, the chance of reinfection or loss of the tooth is greater.

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Endodontic Surgery

endodontic surgeryRoot canal treatment is performed on teeth where the nerve in the tooth becomes infected. The tooth may be painful and an abscess can develop in the bone around the root. Most teeth heal after root canal treatment has been done. In some cases however, an abscess develops around the root tip, even after root canal treatment. This usually occurs when all the infected bacteria could not be removed from within the root, or when the initial infection was severe.Surgery is usually required at this point to remove the bacteria around the root tip. An opening is created through the gum tissue and bone, and the abscess is cleaned out. The tip of the root is cut off, to ensure that the bacteria and any infected tissue is removed. The tip of the root is then sealed with a small filling, and the opening in the gum is closed. If all the bacteria was removed successfully, the bone eventually fills back into the opening. In some cases, the procedure is not successful and the tooth may need to be extracted.

Apicoectomy Procedures

Apicoectomy Procedures

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Dark or Discolored Teeth

dark or discolored teethTeeth become discolored or turn dark for various reasons, however there are two main causes for this phenomenon to occur. Teeth may darken after root canal treatment, caused by the various toxins that exist during the infectious process. Teeth may also discolor if there is a problem with the pulp of the tooth (the innermost layer containing the nerves and blood vessels). An x-ray can usually help to determine what is the causative factor. In this example, we can see that the two upper front teeth are discolored, creating an unesthetic appearance for this individual.

dark or discolored teethWhen we look at the x-ray of these two front teeth,
we can see by the filling material in the roots that these teeth in fact have been treated with root canal therapy. In some cases, internal bleaching may remove the discoloration, however, in many cases a veneer or a crown will be required,depending on the amount of tooth structure remaining.

In situations where the discoloration is caused by a problem in the pulp of the tooth, root canal therapy may be recommended by your dentist to treat the condition.

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