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Root Canal Treatment - conservative approach

RCT was done and failed
The dark area around the roots is infection
10 weeks after retreatment was done
Notice bone regeneration around roots

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How is Root Canal Treated?  


Depending on the symptoms and the stage of the disease, root canal treatment may take one or more visits. The objective of RCT is to clean all the infected tissue out of the canals of the tooth and seal them with special insoluble material- gutta-percha. First doctor will anesthetize the patient with anesthetic solution. After patient is numb, doctor will remove the decay and “open” the tooth to gain access to the nerve. Nerve could be live or already dead depending on the stage of pulp disease. If the nerve is "dead" - non-vital - the infection already can spread to the periapical tissue, and lead to the pulp abscess.  After the crown part of the nerve removed, doctor using special files will clean the inside of canals, widen them and shape them. During the instrumentation, the inside of the canals will be washed (irrigated) with antiseptic solutions. Then canals will be dried with special paper points and sealed with gutta-percha. Gutta-percha has to fill the whole length of the canal up to the apex. Usually doctor will file tooth slightly down, to keep it out of occlusion to prevent pain and place temporary filling. It is very strongly recommended to restore any endodontically treated tooth with post and core and the crown.
In the last few years new technologies and approaches allow dentists to perform root canal treatment in much faster and in more efficient way. The use of rotary instruments for the instrumentation faze of the root canal treatment, can cut treatment time in half or even more. With rotary instruments dentist is able to shape the canal exactly to match the guttapercha, thus providing much better seal of the canal, insuring better results of root canal treatment.
After the root canal treatment procedure is complete, it is normal to expirence some and discomfort especially while biting on the tooth. If it happenes the most discomfort will happen on 3rd or 4th day. one of the reasons of this complication attributed to the pressure tooth receives during the instrumentation faze of root canal treatment. This pressure is significantly reduced by the correct use of rotary instruments, thus reducing post root canal treatment pain to minimum.


Root Canal Re-treatment Do Root Canals always work?  Unfortunately not. The success rate for the root canal treatment according to different studies is 92-96%. Sometimes root canal failures can be attributed to poorly sealed canals, but some times x-ray shows perfectly sealed canal and the periapical infection is still there. What are the options if endodontically treated tooth has the infection? There are few procedures, which could be done to save the tooth.The most conservative one would be a Root Canal Re-Treatment procedure. During this procedure, the doctor will remove any restorations the tooth may have to gain access to the pulp chamber, remove all old filling material from the canals, and do the root canal treatment from scratch as described before. If successful, the periapical infection seen on the x-rays will start to disappear. The principle is to eliminate the cause, and the immune system does the rest. The images of x-ray show huge infection around the roots of previously endodontically treated tooth almost disappear in ten weeks after procedure was done. It can take 6 month before bone fully restores after the treatment.

Decay leading to RCT in two front teeth
Endodontic files used to take measurement
Completed RCT
It may take up to 6 month for bone regeneration at the infection site