Root Canals (Endodontics)
Endodontics is the discipline of dentistry that treats the tooth’s pulp tissue (nerve, blood vessels, and lymphatic systems). The primary purpose of root canal therapy is to remove all pulpal tissues from within the tooth and root(s) and then seal and fill these structures (i.e. deep cleaning followed by a deep filling).
A root canal may be warranted in cases where a tooth has:
- deep decay into the nerve
- experienced blunt force trauma (accidents)
- extreme pain from a dying nerve
- abscess/infection from a dead nerve
- sustained nerve damage from gum disease
- to undergo reconstruction that may expose the nerve chamber
Dr. Nasralla is highly trained and experienced in all realms of endodontics and uses the best technology available, including dental microscopes for increased magnification and illumination in the tooth and roots. Unlike days of old, root canals are typically painless and done in one easy visit with many patients reporting little or no discomfort the next day.
Root Canal Procendure
Dr. Nasralla examines and x-rays the tooth (decayed and infected in this illustration), then administers local anesthetic. Once it is numb, a rubber dam is placed over the tooth to isolate it and keep it clean and free of saliva during the procedure.
An opening is made in the crown (top) of the tooth and very fine, flexible instruments are used to clean out the pulp from the pulp chamber and root canals and to shape the space for fillings.
After the space is cleaned and shaped, the root canal spaces are filled with a biocompatible rubber-like material called “gutta percha”. The gutta percha is placed with an adhesive cement to ensure complete sealing of the roots.A final x-ray is taken and a core build-up (final filling) is then placed in the top of the roots and the tooth. A crown may be necessary to restore the tooth to its full function and beauty.
We deal with the human body, and occasionally it does not heal as expected and a tooth can experience post-treatment infection. In these cases, the dentist must retreat the tooth with a second root canal therapy in the same manner as described above; but by removing all the gutta percha and recleaning the roots. Once thoroughly cleaned and shaped again, the system is resealed and filled as before. More often than not, the tooth responds favorably and the infection and symptoms disappear permanently.
Surgical retreatment (apicoectomy)
An apicoectomy, or root-end resection, is the removal of the root tip and the surrounding infected tissue of an abscessed tooth. This procedure may be indicated when inflammation and infection persists in the area around the root tip but cannot be addressed by retreatment through the tooth.
Step 1: After the tooth and gums are “numbed”, the gum is reflected (lifted) to uncover the underlying bone and the root end of the tooth. The root end is resected (removed) with all the surrounding infected tissue.
Step 2: A root-end filling is placed to seal the end of the root canal and artificial bone is placed in the surrounding space. A few dissolvable sutures (stitches) are placed to hold the gums in place until healing occurs.
Step 3: After several months, the bone and gums have healed (replacing all the artificial bone with natural bone) and all symptoms are gone.
If you suffer from toothaches or think you need a root canal, call Dr. Nasralla at 250-339-2252 or click to request a dental consultation.