Root Canal Therapy or Endodontic Therapy- a Solution Towards Permanent Treatment or a Continuation of Problem and Pain?
Root Canal Treatment Vs Dental Extraction /Implants
Implants are more advanced treatment for tooth material loss which is EXPENSIVE.
Although , RCT is cheaper, but it's long term results heavily rely on the expertise and EXPERIENCE of your DENTIST/ENDODONTIST and eventual restoration (PROSTHESIS/CROWN).
The longevity of RCT can range from 5-20 years depending on the seal achieved during treatment.
FIRST 6 months are CRITICAL.
IF YOU HAVE PAINLESS EXPERIENCE in the first 6 months, most likely the RCT was successful with good seal achieved in the canals. Restoration should be solid so that it does not fracture on stresses of masticatory loads.
Diagnosis and Treatment Planning-Always be conservationist in the start.
3D Root canal Treatment
What is Root Canal Treatment?
It is a permanent treatment for infected carious teeth. Problem with a carious tooth is that it has bacterial invasion in pulp/pulp canals either directly or through irritants produced by bacteria. This results in pulpal inflammation and might be reversible if the bacterial load and source that is the carious dentin is removed within 48 hours after the initial insult to pulp.
Tooth is hollow just like any other part of the body it has nerves and vessels. Simply it is as alive and other parts of body are. Even though caries is a slow process but it does effect a vital part of tooth which can be quite devastating in long run. For eg, as we see in OLD age people who dint care initially and went for extraction of tooth rather saving it through RCT in early age were facing problem of edentulous resorbed ridges in Mandible and Maxilla at a compartively younger age. People don't realize the importance of saving one tooth and extraction of one tooth often starts a chain reaction and results in multiple extraction.
A sequential treatment with root canal treatment seems to be first step for relief of dental pain.
There is a lack of current literature evidence which can clearly define a line in taking a decision when deep caries is present of whether to preserve the dental pulp or to perform Root Canal Treatment.
Inferior Alveolar Nerve damage can occur if extrusion of pulp canal filling material outside the root apex of 2nd Premolar in mandible.
The success rate of single unit dental implant is 95% over 5 years.
The success rate of endodontically treated tooth is 96% over 6 years.
Dental Abscess can be life threatening-Remember Pharoah died of dental caries
How to Obdurate the canals after cleaning and shaping
Types of Root Canal Treatments
Single Visit RCT:
Done is single visit. Found through research that the clinical efficacy is same as compared to Multi Visit RCT.
Multi visit RCT:
done in more than one visits. Cleaning, filing , shaping and than Obturation. Filling and restoration of RCT treated tooth is a different process and requires continuous patience as per the part of the patient.
Crown-Down Technique of RCT.
Hybrid Technique of RCT
Step Back technique of RCT
Protaper system or Rotary RCT.
All of these treatments are useful in different cases but overall protaper system is the most beneficial and accurate along with effective.
Protaper System of RCT-Best Treatment
Root Canal Therapy also called ENDODONTIC Therapy
INFECTED PULP inside of the TOOTH (ROOT) is removed surgically.
The TOOTH becomes DEAD and the canal becomes FREE FROM BACTERIA and INFECTION.
The nerve tissues, blood vessels and other cellular components are also removed from inside the tooth surgically.
THE HOLLOW root canals are then filled with an INERT , STERILIZED, NON-INFECTIVE MATERIAL called "GUTTA PERCHA".
A certain TYPE OF CEMENT is used to BIND this INERT material with the walls of the ROOT CANAL.
The goal is to SALVAGE the tooth structure after complete eradication of carious tooth structure AND infection.
Filling of Canals in RCT
The diagnosis of an INFECTED TOOTH which is a candidate for ROOT CANAL THERAPY is based on
DENTAL PULP Tests
DEVITALIZATION of the PULP CHAMBER and ROOT CANAL
This is an important part of RCT after the canal has been cleaned and prepared.
The root canal is FLUSHED with an irrigant.
5% sodium hypochlorite is the most commonly used liquid.
2% chlorhexidine gluconate is used somewhat commonly in older practices.
17% ethylenediaminetetraacetic acid (EDTA) is a NEW choice of MATERIAL used in more ADVANCED Practices.
USED RARELY is a Mixture of citric acid, doxycycline, and polysorbate 80 (detergent) (MTAD)
MOLARS and PREMOLARS are used to bear maximum load of MASTICATION.
Therefore, the CROWN is used on those RCT treated teeth.
IMPORTANT to note is the CANAL should be properly sealed so that the canals remain impermeable to infective BACTERIA's.
Post OPERATIVE pain is common, specially in a SINGLE VISIT RCT
ROTARY AUTOMATIC INSTRUMENTS are associated with LESS PAIN as compared to manual instrumentation root canal in some literature.
FIRST 24 hours are critically important in this regard.
Usually the physicians prescribe NSAID's analgesics to control pain. Rarely, your dentist can prescribe NARCOTICS to control the pain.
© 2012 Moiz Ahmad Khan