Surgical vs. Non-surgical Root Canal Therapy
What is a Root Canal?
A root canal is an endodontic procedure performed by an endodontist in an effort to save a natural tooth. It is one of the most common dental procedures done mainly due to inflammation and infection of the dental pulp.
During a root canal the affected pulp is removed. The tooth will remain functional since the only function of the pulp in a mature tooth is to provide sensations of hot and cold. Once the diseased or damaged pulp is removed, the tooth is cleaned and sealed to protect it from further damage. It is done under local anesthetic and is not as painful as it sounds.
Either a surgical or non-surgical root canal therapy can be done to ensure you keep your natural tooth and smile. A choice between the two may depend on the extent of damage and the severity of the symptoms, among other factors the endodontist may discuss with you.
It usually takes a few visits to the endodontist to complete the root canal. Pre-treatment with antibiotics may be needed to reduce inflammation and swelling prior to the procedure.
What Causes Pulp Damage?
An untreated cavity is commonly the cause of an infected or damaged pulp. Bacteria surrounding the decaying tooth eats through the tooth’s enamel and infect the pulp. Infection of the pulp may also be due to trauma resulting in a chipped or fractured tooth which causes pulp tissues to die. Large fillings and repeated dental procedures also contribute to pulp damage.
In cases of severe infection, an abscess may form and can damage the bone structure surrounding the tooth. When the pulp is in any of these conditions a root canal may be necessary to repair the tooth and save it from extraction.
Symptoms of Damaged Pulp
The dental pulp is found within the root canal(s) of the tooth. It contains nerves, blood vessels, and connective tissues. When the pulp becomes damaged due to injury, inflammation, or infection the following symptoms may occur. Note, however, symptoms may not be present in some cases:
- Prolonged sensitivity to hot or cold temperatures
- Severe toothache
- Darkening of the tooth
- Tenderness or swelling of the gum surrounding the tooth
- Recurring pimples on the gum
- Presence of an abscess
Root Canal Diagnosis
A surgical or non-surgical root canal therapy will be needed to salvage the tooth. In general, these are two different procedures but bear some similarities. The primary goal, however, is to save the tooth.
Your endodontist will first examine your affected tooth to determine if a root canal is in order. An endodontist is a dentist who specializes in treating infected or damaged dental pulp and repairing the tooth. Usually, you would be referred to an endodontist by your primary care dentist.
Diagnosis involves an X-ray of the tooth to check for signs of infection and damage to the bone surrounding the teeth. A pulp vitality test may also be done. If there is an infection and it is not chronic, for example there is no abscess present, the endodontist may be able to begin the root canal procedure right away.
Non-Surgical Root Canal Procedure
Non-surgical or conventional root canal therapy is the most common type of root canal done to protect your natural tooth. It is quite like getting a really deep filling done. It is a more detailed procedure than a normal filling as drilling goes farther down to the root of the tooth.
After treating you with local anesthetic, the endodontist will drill down to the root canal to remove the diseased pulp, clean, and fill the tooth to prevent further infection or damage. Sodium hypochlorite is used to disinfect the canals and pulp chamber to remove all traces of bacteria.
Where the tooth is badly damaged, e.g., from decay, the endodontist may need to reconstruct the natural form of the tooth using metal posts within the canal. A temporary crown will be placed over the tooth and later replaced by a permanent crown. It is placed to restore bite functions and prevent further tooth damage.
A non-surgical root canal be done in one or more visits and will require at least one follow-up visit.
Surgical Root Canal Procedure
When a non-surgical root canal fails or is not enough to save the tooth, a surgical root canal, also known as endodontic surgery or root canal re-treatment, becomes necessary. This minor surgery is done under local anesthetic to numb the area being treated.
In addition, a surgical root canal may be performed to identify hidden canals or tiny fractures which may have gone undetected by X-rays during initial treatment. It is also done to treat bone surrounding the tooth, damaged root surfaces or to remove calcium deposited in root canals.
Sometimes a surgical root canal is necessary to perform an apicoectomy, also known as a root-end resection. An apicoectomy is typically done when inflammation or infection continues to threaten the tooth’s bony structure, after a conventional root canal.
This occurs if bacteria remain after the pulp was removed and the canal sealed. Other times, bacteria may be re-introduced through a new decay or crack or fissure that develops within the tooth after the initial root canal.
Unlike with the non-surgical root canal, the endodontist gets to the root of the tooth through a small incision in the gum. This route is taken to avoid destroying the restoration done during the original root canal and prevent weakening of the tooth.
Once the root is accessed, inflamed or infected tissue and the tip of the root or root end is removed. The end of the root canal may be sealed using a tiny filling also called a root-end filling. If the infection left a huge space, bone grafting may be done to help bone regrow and refill the space.
Do I Need a Surgical or Non-Surgical Root Canal?
Surgical and non-surgical root canal treatment have one common purpose—to save the tooth from further damage or extraction. In both surgical and non-surgical root canal, the root of the tooth is accessed to remove inflamed or infected tissue and stop further tooth damage.
Anesthetic is also used in both instances to prevent pain or discomfort. The main difference between the two is the techniques used and the nature of the treatment.
Surgical root canal goes a little further and is necessary in complex cases where inflammation or infection persists, the root-end needs to be re-sectioned, calcium deposits need to be removed, or the tooth structure needs to be rebuilt.
Your dentist may be able to determine which type of root canal you will need before referring you to an endodontist. After carefully examining the affected tooth, the endodontist can accurately determine if a surgical or non-surgical root canal is best for you.
Whichever type of root canal treatment is needed, these procedures can save your natural teeth and prevent costly tooth replacement procedures involving the use of dental bridges or dental implants.
Finding a Good Endodontist
All endodontists are not created equal. The difference lies in their years of dental practice, expertise, and the technology and techniques used.
York Hill Endodontics has performed successful root canals for many patients for more than 50 years. This is why it has been a popular choice for individual living in Greater Toronto Area.
Article originally appeared at: https://www.clocktower-dental.com/
Author: Clock Tower Dental