In some cases, root canal retreatment may still leave small canals infected, preventing proper tooth restoration. When this occurs, the infected tissue around the end of the root, or apex, is removed along with the root tip, and the filling procedure is performed. This is known as endodontic therapy and is done to prevent tooth extraction. Endodontic therapy is also called root-end surgery, which involves cutting the tissue around the gum to access the bone and remove the infected tissue. It’s a common misconception that if conventional root canal treatment fails, microsurgery is the only option. However, most endodontic failures can be treated with re-endodontic treatment, and microsurgery is not always necessary. If apical surgery is deemed necessary, a surgeon or an endodontist will perform the procedure. According to an experienced endodontist in Toronto, microsurgery is unnecessary in most cases of endodontic failure. It’s crucial to consult with a dental professional to determine the best course of action for treating any dental issues and maintaining optimal oral health.
When Is Endodontic Treatment Necessary?
There are several situations where periapical surgery, also known as apical dental surgery, may not be recommended. For instance, if root canal treatment is still possible, it is preferable to surgery despite the uncertain outcome. Additionally, anatomical considerations such as the presence of vessels and nerves or bony structures like the external oblique ridge or the possibility of maxillary sinus opening may also make periapical surgery unfeasible. Patients with low crown-to-root length ratio or systemic problems may also not be suitable candidates for the procedure. Other factors that may make periapical surgery necessary include anatomical problems like calcification, obstruction, or curvature of the root, dental restorative considerations, and mistakes during work. Large unhealed lesions after endodontic treatment may also require periapical surgery.
In cases where periapical surgery is not recommended, tooth extraction may be the only alternative. However, this option may require additional procedures like implants, bridges, or removable prostheses to restore chewing function and prevent displacement of adjacent teeth. Since these alternatives involve surgery or other dental procedures on adjacent healthy teeth, periapical surgery is usually the most biological and cost-effective option for maintaining oral health. It’s crucial to consult with a dental professional to determine the best course of action for each patient’s unique dental situation.
The pulp treatment mentioned earlier may need to be performed two or three times, depending on the severity and complexity of the disease. This procedure is carried out by an endodontist, a root canal specialist who has undergone extensive training. During the first appointment, the area around the infected tooth is numbed by the dentist using special anesthetics. The dentist then creates an opening on the top of the tooth to access the pulp and root canal. The infected canal is then thoroughly cleaned, and the bacteria are removed from the pulp.
After the procedure, the dentist fills the root canal with a temporary filling. In the next appointment, the temporary filling is removed, and a durable crown or filling is placed on the tooth. The tooth’s functionality is then checked, and in some cases, a third appointment may be necessary to ensure the tooth is working correctly. The success of the pulp treatment depends on the dentist’s expertise and the patient’s oral hygiene habits. It’s important to follow the dentist’s post-treatment instructions carefully and maintain good oral hygiene practices to ensure the tooth remains healthy and functional.