ROOT CANAL TREATMENT
Root Canal Treatment
Root canal treatment or endodontic management is done when a tooth is in a compromised situation due to any injury
1. Physical injury
- Traumatic injury or excessive biting forceCracked tooth
- Fractured tooth
2. Mechanical injury
- Attrition of enamel
- Abrasion as wear and tear of tooth
- Periodontal lesion or weakening of tooth
3. Chemical injury
- Caries
- Erosive lesions
Symptoms
1. Throbbing pain: could be felt during taking hot or cold beverages or while consumption of sweet food.
2. Infection:in form of swelling in mouth or abscess with pus discharge from sinus tract
3. Periodontal abscess:in form of swelling around gum
Necessity of treatment
- To get rid of pain
- To eliminate infection
- To restore back tooth functionability
Not choosing the root canal treatment can lead to
- Severe pain & discomfort
- Swelling
- Loss of tooth
Post & Core
This treatment is done in a root canal treated tooth ( though not necessary in every case) where there is not enough tooth structure present. A post is inserted after removal of the root canal filling, up to 2/3 length of the root. After that a filling is done over it.
Indications
RCT treated tooth in which it is deemed necessary to improve
- Longevity of restoration
- Enhance prognosis and function of tooth restoration and crown
- Protect the tooth from fracture
- Provide anchorage to coronal restoration and crown
- In case of weak tooth structure
- In case of heavy occlusal forces
material choice
1. Prefabricated fiber post:
- it has better tensile strength
- good adhesion with root dentin
- better aesthetic
2. Metal post
- Rarely used now a days because of poor esthetic and size
When a pulp is extracted out of a decayed tooth and the canal treated and filled the gap in a manner that it may be compatible with a physiologic reaction, we all expect to get a satisfactory and successful outcome. However, many times the treatment is carried out in such a way that it antagonizes the biologic processes of repair, which leads to have many failures and arise the need for the revision of previous non-surgical root canal treatment.
The Need of Revision Re-RCT Treatment –
The need for revision of previous non-surgical root canal procedure is quite common in today’s practice of endodontics. The starting of recurrent pathosis can be because of some technical inadequacies in the previous treatment.
Fortunately the label of root canal failure is not the basis of extraction. In the revised treatment your dentist (Endodontist) should commit to perform all aspects of treatment to higher level. These cases are more difficult and may have some compromised situations. With good handling of these cases and clinical expertise success rate could be above 90% in such cases.
It can be pretty difficult for an Endodontistto admit that he/she has failed in the previous treatment and needs to revise the Re-RCT at no extra cost or refer the patients to a more capable specialist. It is easier to condemn the tooth and reap the rewards of impending implants than to commit to perform the revision of previous non-surgical root canal procedure at a higher level. However, it should not be in this way. If a previous procedure of Re-RCT is failed, the Endodontist should not hesitate in accepting the truth and go for the revision treatment.
The purpose of revision Re-RCT treatment is to use higher techniques and tactics for the successful revision of failed treatment. The revision of Re-RCT treatment tends to be more daunting and typically involves the compromised circumstances. Furthermore, the treated teeth that require revision have undergone extensive restorations and need specific access techniques which were not commonly needed for initial treatment. The revision treatment focuses on the successful removal of restorative and root canal filling materials. After removing the restoratives, professional techniques are applied for cleaning, reshaping, disinfecting and reobturating the canals.
Recommendations for Removal of Existing Restorations –
Whether initial treatment or revision, in general, root canal treatment does not require the removal of existing crowns. The patients can prefer to preserve satisfactory restorations. However if due to existing crowns, the ability to revise the previous Re-RCT is compromised, it behooves the clinician to go for the dismantling of the restoration.Revision of previous Re-RCT can sometimes be accomplished while preserving the existing restoration. So, it is not always essential to dismantle the crown. Crown or restoration removal turns to be an unavoidable necessity when recurrent caries is found to extend well under the crown margins and is often the etiology of periapical pathosis.
Following a thorough discussion of the revision treatment of previous non surgical root canal treatment options and potential outcomes, the patients can expect to get the satisfactory and successful result of revision Re-RCT issues and enjoy an improved oral health.