What is involved in root canal treatment?
The RCT procedure will usually involve the following stages:
- Pre-operative X-ray: before starting RCT your dentist should always have a current X-ray to show:
- The extent of any bone destruction at the root apex.
- The shape, patency (whether the canals are open or blocked) and length of the roots.
- The presence of any decay in the tooth.
Are there different types of root canal treatment?
As well as the standard RCT outlined above there are several other treatments which relate to the root canal and dental pulp.
If a first attempt at performing RCT on a tooth has failed, it may be possible to remove the root filling material and attempt a retreatment. The success rate for re-RCT is slightly lower than for a first RCT on a tooth but there are many instances where they can be effective. For example, if an RCT failed because one of the root canals in a molar tooth was not identified and cleaned then a second attempt which filled all the canals might be more successful.
If a tooth has been root filled to a high standard but there is still ongoing infection in the bone at the tip of the root it might not be possible to attempt a re-treatment without damaging the tooth. In these cases a dentist might raise a flap of gum and remove bone to expose the tooth root. The leaking root tip can be then be cut off and the root canal sealed directly to ensure that no bacteria can leak from within the remaining root canal. This procedure usually takes about an hour and is performed under local anaesthesia.
Pulp cap and pulpotomy
If decay removal or a tooth fracture results in a small part of a healthy pulp becoming exposed, your dentist may try to retain the pulp vitality, or keep the pulp alive. This is achieved by placing a special layer of material, which promotes the formation of new dentine, on top of the exposed pulp before placing a filling. This technique is called a direct pulp cap. Alternatively, if only the exposed part of the pulp appears to be infected or inflamed then just the top half of the pulp can be removed, from within the pulp chamber. This leaves the healthy pulp still alive in the root canals which can be sealed off and protected before the tooth is filled. Follow-up X-rays and vitality tests are necessary to monitor the success of these 'vital pulp' techniques.
Further reading and references
Root canal treatment - site includes 'find a member' function; British Endodontic Society
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