Root canal treatment or an implant?

Posted by Dental News Team On June - 30 - 2010

Which therapy is appropriate for me-root canal treatment or an implant?

There are endless horror stories about “dead” teeth, meaning root canal treatment was performed. But: There are no such things as “dead” teeth. The tooth is a mineral and thus “lifeless”.
The tooth has a connective tissue- pulp. If the pulp gets infected, e.g. caused by cavity, a root canal treatment should be performed. If a bad root canal treatment is performed- without a coffer dam, visual augment and sterile endo box- the root treated tooth is like poison for the body!

A well  treated root canal on a tooth can last a whole life!
The sealing of the tooth by the crown is also important-e.g. with a ceramic inlay or a crown. If the canals are well cleaned and filled as well as the ingresses are sealed by inlay or crown, the success rate of the whole procedure is pretty good. !

Usually this treatment is very expensive, which lead us to the headline. It can cost 700€-1500€-prognosis and thus durability should bear in relation to the effort.

If there are more problems (bone loss, heavy convoluted canals, focus on the root tip, big fillings) a tooth needs to be extracted. In this scenario an implant might be the solution. Remember:
-Heavy s

If you are a heavy smoker or you don´t like mouth hygiene that much, then a tooth implant is probably not the best choice, you try to save the tooth intensively.

The anamnesis is important in the decision making what is the best treatment-implant or root canal treatment; it varies from case to case.

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Quiz Score! – Congratulations, you are now a root canal expert!

Posted by Dental News Team On April - 6 - 2010

Our topic in the last weeks was root canal treatment and its risks! (10/10)

The last report showed three different pictures!

Pic 1

The molar has never received root treatment, just root tip resection and retrograde filling. After a bridge was inserted, the patient complained of pain, and some weeks later, the dentist skipped performing root treatment in favor of root tip resection, in order to avoid damaging the bridge. Two years later, the tooth can no longer be saved, because this faulty treatment could not prevent the spread of the inflammation – and this caused the bone to recede. The tooth is no longer surrounded by bone, but by inflamed tissue!

Pic 2

The back root is evenly filled to the tip – unlike the front root!

Pic 3

The front tooth (shown by the green arrow) is well-filled, while the back tooth (red arrow) has not been treated at all, and you can clearly see the inflammation progressing in the bone.

More on x-rays and dental films and pictures here!

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Small filling – big filling – root treatment – root tip resection – removing a tooth

Does this process look familiar to you?

Whether it does or not, we would like to explain why this happens. It may help some of you to avoid this, while others will at least realize that there is no such thing as bad teeth!

1. People rarely ever have bad teeth and if this is genetic, all of a person’s teeth are affected!

Why do you mostly have fillings in your side teeth? Find out here!

2. Good, now we know that your “bad teeth” are at least partly your own “fault”! Unfortunately, dentists only rarely inform their patients about why things like this happen, they usually just keep drilling, while your fillings keep getting bigger and bigger, until one fine day you need a root canal treatment.

The right way to perfom root treatment is … here we have a video for you, but be sure to come back after your trip to dental land!

3. Hopefully your root treatment was not performed the wrong way, without a coffer dam, enlargement and sterile instruments.

Now, your root canal may contain a bunch of bacteria from saliva, or unsterile instruments used during treatment. These bacteria continue to multiply unchecked. Your immune system does manage to get rid of some of them, but not all, and years later you develop a bone infection at the tip of your root, caused by the bacteria in your root canal.

4. This usually calls for a root tip resection – depicted here!

Without cleaning the canal (orthograde WSR), or sealing the canal from behind (retrograde WSR)this area can again start to cause problems, making it necessary to remove the tooth completely!

Imagine all the trouble you could have saved yourself if you had already known this – Dentalnews.en readers always have something to smile about!

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Risks of a root canal – root tip resection?

Posted by Dental News Team On March - 29 - 2010

Our topic in the next weeks is root canal treatment and its risks! (8/10)

If bone is already too badly inflamed after faulty root treatment, then it is no longer enough to clean out the inside of the tooth. The inflammation is too extensive. One option is to perform a root tip resection.

But root tip resection just means removing inflamed tissue, the cause of the inflammation, the contaminated canal, is left untreated. Either a revision is performed to redo root treatment as part of the operation – which is then referred to as root tip resection with orthograde filling, or the root canal is sealed up from behind – referred to as root tip resection with retrograde filling.

Why from behind? Well, sometimes it is no longer possible to perform a revision starting from the crown e.g. in the case of pivot teeth, or if the structure of the root canal is too complicated, or part of an instrument has broken off during treatment, etc. Depending on the circumstances, this sealing method can also be used to kill off the bacteria still left in the root canal, because you cut the bacteria off from their source of food, and the tooth is saved!

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Can you renew or redo a root canal?

Posted by Dental News Team On March - 25 - 2010

Our topic in the next weeks is root canal treatment and its risks! (6/10)

Redoing poorly performed root treatment is known as „Revision“, and is definitely necessary!

Revision, as a rule, involves more work than standard root treatment. But most medical insurers do not even pay, because you could have gotten the work done properly the first time around. This is why not many dentists like to perform revisions and go right on to root tip resections and/or tooth extractions.

Whether a revision will be successful or not depends on how heavily contaminated the tooth is by bacteria on the inside of the tooth! And also on how well the original root treatment was performed. Sometimes the bone is so badly inflamed that revision no longer helps, and you have to opt to perform a root tip resection.

A root tip resection involves getting the inflamed tissue, resulting from faulty root treatment, out of the bone. But simply removing the tissue is not enough – you also have to clean out the inside of the tooth. If this is not done, then you may be all right for a while (a year or two), but then the problems start up again!

Unfortunately, dentists usually don’t bother performing more than a root tip resection, and what the patient is not aware of is that this means simply removing the inflamed tissue, not treating the cause, which is the contaminated canal. And if the canal is not treated, then the problems return!

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