Saving teeth with root canal treatment can preserve surrounding bone, gum and biting forces.
Saving a tooth may help to preserve the surrounding bone, maintain the gum level and help to protect other teeth by preserving the loading patterns and forces that help regulate the bite.
The aim of root canal treatment is to remove the inflamed and/or infected dental nerve tissue from within root canal, after which the complex root canal system is thoroughly disinfected and sealed with a root filling.
In some situations we are able to avoid root canal treatment altogether, instead we use a technique called 'pulp capping' to preserve the health of the pulp tissue by sealing it with a biocompatible silicate cement. In these cases we usually then restore the tooth with a bonded filling rather than a crown to permit further treatment later on if need be. Pulp capping can only be performed in specific situations and therefore requires careful assessment beforehand.
In our practice, root treatment is usually completed in a single session by an endodontic specialist, and the treated tooth may be permanently restored soon after. Root treated teeth must restored appropriately, as these teeth are sometimes used as supports for dental bridgework and removable dentures.
Root treated teeth are always compromised teeth, as a result of extensive decay, trauma, breakdown or advanced wear and tear. The root canal treatment itself inevitably further weakens the tooth, and this must be taken into account. We make sure that the tooth can be predictably restored after treatment. This investigation may include removing all the decay and filling material from the tooth, and a preliminary 3D scan of the tooth, to check for restorability.
We use crowns or bonded resin, reinforced or porcelain restorations, to re-establish the integrity of the tooth by holding the hollowed out structure together. Towards the front of the mouth, teeth generally require the use of bonded tooth-coloured restorations or porcelain crowns, and towards the back of the mouth we advise either a crown or a less invasive 'onlay'.
Extensive decay or trauma may mean that little of the tooth remains above the gum-line, despite the fact that a viable root remains. In this event a post may cemented into the root canal to provide retention for a bonded foundation and crown.
Occasionally, even well-root filled and beautifully restored teeth may eventually fail through re-infection, dental decay and/or progression of microscopic cracks. These teeth may then be replaced with fixed bridgework, implants, or removable dentures.