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The type of endodontic treatment that may be recommended depends on
how seriously the pulp is affected, an evaluation of the tooth and
the results of an X-ray. There are two types of pulp therapy,
depending on the condition of the tooth pulp:
1) Vital Pulp Therapy the goal of vital pulp therapy is to
preserve and protect the pulp. In this procedure, the pulp is only
removed from the crown of the tooth and not from the root. Vital
pulp therapy is only recommended if there is no swelling or abscess
and the tooth is not loose. There are four main types of vital pulp
therapy for baby teeth:
Protective Base - This treatment is done when the tooth is
only affected by decay and the pulp is healthy. First the decay is
removed, then a protective material is inserted into the tooth and
then the tooth is filled.
Indirect Pulp Cap - This treatment is carried out when decay
has come close to the pulp but does not reach it. The endodontist
will remove as much of the decayed matter as possible without
touching the sensitive pulp. A protective dressing is placed to
cover the pulp which helps to speed up the healing process. A
filling is placed on top of the dressing.
Direct Pulp Cap - This procedure is performed when a little
bit of the healthy pulp has been exposed due to tooth decay or
fracture. Medicine is applied to the exposed pulp to prevent
infection, then the pulp cap is placed and the tooth is filled.
Direct pulp cap procedures have a higher success rate in permanent
teeth, so this therapy is rarely used for baby teeth.
Vital Pulpotomy - This treatment is an option when only the
crown portion of the pulp has been damaged by decay or trauma and
the root portion is still healthy. The dentist will remove all tooth
decay along with the damaged portion of the pulp, leaving the
healthy root pulp intact. Medicine is applied to the exposed portion
of the root, and the tooth is filled and enclosed with a stainless
steel crown. The crown protects the weakened tooth from future
fracture or damage. If a vital pulpotomy is performed on a child's
permanent tooth, it is usually done as a temporary measure to allow
the tooth's root to finish growing. If necessary, a complete root
canal treatment may be performed once the tooth root has matured.
2) Non-vital pulp therapy - Non-vital pulp therapy (also
known as root canal treatment) is required out when there is no
chance of saving the pulp. The endodontist will remove the entire
tooth pulp from inside the tooth and will clean and fill the canals
with a special material. A stainless steel crown is then placed on
the tooth to prevent it from fracturing.
Extraction versus Endodontic Treatment for Primary Teeth
Many factors need to be considered when determining whether an
extraction or an endodontic treatment is the right choice for your
child. The choice of treatment depends on factors such as:
The location of the tooth that is affected.
The tooth's useful remaining life.
The extent to which the pulp and tooth have been damaged.
Whether neighboring bone and gum tissue have been affected.
Whether the tooth can be properly repaired after the root canal is
performed.
Whether the patient has a healthy or abnormal immune system. An
extraction is recommended if child has a weak or compromised immune
to avoid the chance of infection and resulting complications for the
child.
Endodontic Retreatment
An endodontic retreatment is performed if after the first treatment
the tooth has not healed as expected or if the pain continues.
Inadequate healing can be a result of:
Complicated canals were missed during the first treatment
There was a delay in placing the crown or restoration
Saliva contaminated the inside of the tooth
No treatment of curved and narrow canals
Fresh decay exposing root canal fillings can result in infection
Loose fillings can lead to new infection
Fractured tooth
Endodontic retreatment can be a simple non-surgical procedure, a
complex surgical one or a mix of both. The endodontist will inform
you about the most suitable treatment option for your case.
The endodontist will create an opening into the restoration to reach
the root canal filling material. He may have to remove the crown,
post, and core material before he can reach the root canals. The
post and other material are loosened using a post remover or an
ultrasonic hand piece. The endodontist then examines the inside of
the tooth to locate additional canals or changes in the structure of
the tooth.
The endodontist fills and seals the cleaned canals and a temporary
filling is placed in the tooth. He may take X-rays to verify that
the cleaning is as close as possible to the end of the root.
Endodontic surgery may be required if the canals are very narrow or
there is blockage. An incision is made so that the other end of the
root can be sealed satisfactorily.
Endodontic Retreatment
An endodontic retreatment is performed if after the first treatment
the tooth has not healed as expected or if the pain continues.
Inadequate healing can be a result of:
Complicated canals were missed during the first treatment
There was a delay in placing the crown or restoration
Saliva contaminated the inside of the tooth
No treatment of curved and narrow canals
Fresh decay exposing root canal fillings can result in infection
Loose fillings can lead to new infection
Fractured tooth
Endodontic retreatment can be a simple non-surgical procedure, a
complex surgical one or a mix of both. The endodontist will inform
you about the most suitable treatment option for your case.
The endodontist will create an opening into the restoration to reach
the root canal filling material. He may have to remove the crown,
post, and core material before he can reach the root canals. The
post and other material are loosened using a post remover or an
ultrasonic hand piece. The endodontist then examines the inside of
the tooth to locate additional canals or changes in the structure of
the tooth.
The endodontist fills and seals the cleaned canals and a temporary
filling is placed in the tooth. He may take X-rays to verify that
the cleaning is as close as possible to the end of the root.
Endodontic surgery may be required if the canals are very narrow or
there is blockage. An incision is made so that the other end of the
root can be sealed satisfactorily.
Endodontic Dentistry
Root Canal
Therapy
Endodontic
Dentistry
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