Root Canal Treatment (RCT) is the removal of the tooth's pulp, a small, thread-like tissue in the center of the tooth. Once the damaged, diseased or dead pulp is removed, the remaining space is cleaned, shaped and filled. This procedure seals off the root canal. Years ago, teeth with diseased or injured pulps were removed. Today, root canal treatment saves many teeth that would otherwise be lost.
The most common causes of pulp damage or death are:
A cracked tooth
A deep cavity
An injury to a tooth, such as a severe knock to the tooth, either recent or in the past.
Once the pulp is infected or dead, if left untreated, pus can build up at the root tip in the jawbone, forming an abscess. An abscess can destroy the bone surrounding the tooth and cause pain
How long will the Restored Tooth Last?
Your treated and restored tooth/teeth can last a lifetime with proper care. Because tooth decay can still occur in treated teeth, good oral hygiene and regular dental exams are necessary to prevent further problems.
As there is no longer a pulp keeping the tooth alive, root-treated teeth can become brittle and are more prone to fracture. This is an important consideration when deciding whether to crown or fill a tooth after root canal treatment.
To determine the success or failure of root canal treatment, the most relied-upon method is to compare new X-rays with those taken prior to treatment. This comparison will show whether bone continues to be lost or is being regenerated.
Root canal treatment is a procedure with a high success rate of more than 95%. Unfortunately, in a 5% of cases root canal complications result in a failed root canal. The success of root canal therapy depends on a number of different factors and the likelihood of failure can vary considerably from case to case.
However, some of the root canal complications are not predictable.
If after the endodontic treatment, the inside of the tooth or the tissues surrounding the root remain infected, the procedure is considered failed. The usual symptoms of failed root canal treatment include tooth pain and tenderness or swelling of the gums in the area near the tooth.
In other cases, problems such as a new infection can develop without any symptoms. Follow up examinations and x-rays are very important in determining the success of a root canal treatment. X-rays will help the dentist to detect any sign of inflammation in or around the tooth that could indicate root canal complications. Root canal complications may appear immediately following the endodontic treatment, or even after many years.
Root canal complications can cause a failed root canal, but the tooth has usually a second chance. If the treatment has failed, the dentist will evaluate the condition of the tooth and the reasons of the root canal complications, in order to decide if the tooth can be saved. Unfortunately, in some cases the tooth can not be saved and it has to be extracted. A bridge, implant or a partial denture has to replace the lost tooth.
There are three options available after a failed root canal :
The first option for solving the problems of a failed root canal is the root canal re-treatment. The procedure is similar to the regular treatment but much more difficult. Rarely general dentists will perform the root canal re-treatment themselves, usually they refer the patient to a specialist endodontist.
Depending on the nature of the problem, the endodontist may decide that endodontic surgery must be performed in order to save the tooth. The procedure is called apicoectomy and it involves the surgical removal of the root’s tip (apex). A small filling (retrofill) is then used to seal the root.
The chances for a successful treatment of a failed root canal are between 50% and 75%. In some cases, despite root canal retreatment or endodontic surgery, tooth extraction must be performed. The lost tooth is recommended to be replaced as soon as possible to prevent more teeth problems The best solution for tooth replacement after extraction is to replace the lost tooth with a dental implant.
At Denticare, we have expertise for the retreatment of failed procedures.