Technology and Equipment
Surgical microscope
At MedArt Endodontics, we perform all endodontic procedures using a dental operating microscope by Carl Zeiss.
Magnification and enhanced illumination provided by this surgical microscope aid in finding calcified canals, locating crack lines and root fractures during root canal treatment and endodontic surgeries, identifying root resorption. According to American Association of Endodontics, research has proven much more successful outcomes for patients using this technology than compared to treatment without enhanced vision.
We cannot treat what we cannot see!
Digital radiography
Radiography is essential for the successful diagnosis and treatment of dental disease. Digital radiography uses small intraoral sensors, instead of x-ray film, to instantly capture dental images on computers. It requires significantly less radiation. The digital images are magnified allowing us to better communicate and explain diagnosis and treatment options. Digital radiography makes communication with your general dentist and your insurance provider more efficient.
3D imaging – CBCT
Cone Beam Computed Tomography
Unlike CBCT, digital and conventional radiography provide the clinician with only a 2-D image of 3-D objects. Objects such as the tooth, the jaw bone, soft tissue, e.t.c. can only be seen in 2D. However, CBCT allows dentists to evaluate the area of interest in 3D, resulting in the best possible diagnosis of the potential disease. CBCT is also essential in treatment planning for surgical cases, working as a guide for effective treatment. A precise diagnosis is the key to a successful treatment.
At MedArt Endodontics, we use a Morita Veraviewepocs 3D R100. It delivers superior clarity and a low patient radiation dose from small to large fields of view.
Tooth Anatomy
The anatomy of the tooth consists of crown (visible part of the tooth) and root (hidden part of the tooth). The root of the tooth functions as an anchor for the tooth and allows for blood and nerve supply to enter the tooth to maintain its viability.
Inside the tooth, under the white enamel and a hard layer called the dentin, is a soft tissue called the pulp. The pulp contains blood vessels, nerves and connective tissue and creates the surrounding hard tissues of the tooth during development.
The pulp extends from the crown of the tooth to the tip of the roots where it connects to the tissues surrounding the root. The pulp is important during a tooth’s growth and development. However, once a tooth is fully mature it can survive without the pulp, because the tooth continues to be nourished by the tissues surrounding it.
Our Services
“Endo” is the Greek word for “inside” and “odont” is Greek for “tooth.” Endodontic procedures treats the inside of the tooth.
Root Canal Treatment
Root canal treatment is designed to eliminate bacteria from the infected root canal, prevent reinfection of the tooth and save the natural tooth. When one undergoes a root canal treatment, the inflamed or infected pulp is removed from the root canal system and is carefully cleaned and disinfected, then filled and sealed.
Endodontic Retreatment
With proper care, even teeth that have had root canal treatment can last a lifetime. But sometimes, a tooth that has been treated doesn't heal properly and can become painful or diseased months or even years after treatment. If your tooth failed to heal or develops new problems, you have a second chance. An additional procedure may be able to support healing and save your tooth. If you have pain or discomfort in a previously treated tooth, talk to an endodontist about retreatment.
As occasionally happens with any dental or medical procedure, a tooth may not heal as expected after initial treatment for a variety of reasons:
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Narrow or curved canals were not treated during the initial procedure.
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Complicated canal anatomy went undetected in the first procedure.
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The placement of the crown or other restoration was delayed following the endodontic treatment.
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The restoration did not prevent salivary contamination to the inside of the tooth.
In other cases, a new problem can jeopardize a tooth that was successfully treated.
For example:
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New decay can expose the root canal filling material to bacteria, causing a new infection in the tooth.
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A loose, cracked or broken crown or filling can expose the tooth to new infection.
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A tooth sustains a fracture.
Apicoectomy/Endodontic Surgery
Sometimes, a nonsurgical root canal therapy won’t be sufficient to save your tooth.
Apicoectomy (“apico”-apex or end; “ectomy”-removal), or endodontic surgery, can be recommended to locate hidden and accessory canals, root cracks and fractures and to remove a cyst attached to the root tip.
This procedure is performed under the visualization of the surgical microscope to be able to localize all possible source of persistent infection such as microcracks and hidden canals.
A local anesthesia will be administered and incision in the gum tissue will be made to expose the root tip. The inflamed tissue will be removed along with the root tip, and a root-end biocompatible filling material will be placed to prevent reinfection. The gum tissue will be sutured. In the next few months, the bone will heal around the root. Most patients return to their normal activities the next day.
Cracked Tooth
Whether your tooth cracks from an injury or general wear and tear, you can experience a variety of symptoms ranging from erratic pain when you chew your food to sudden pain when your tooth is exposed to very hot or cold temperatures. In many cases, the pain may come and go and your dentist may have difficulty locating the tooth causing the discomfort. If you experience these symptoms or suspect a cracked tooth, it’s best to see an endodontist as soon as possible. Endodontists specialize in saving cracked teeth and will cater treatment to the type, location, and extent of the crack. The sooner your tooth is treated, the better the outcome. Once treated, most cracked teeth continue to function as they should, for many years of pain-free biting and chewing. There are many different types of cracked teeth. The treatment and outcome for your tooth depend on the type, location, and extent of the crack.
Craze Lines
Craze lines are tiny cracks that affect only the outer enamel. These cracks are extremely common in adult teeth. Craze lines are very shallow, cause no pain, and are of no concern beyond appearances.
Fractured Cusp
When a piece of a tooth’s chewing surface breaks off, often around a filling, it’s called a fractured cusp. A fractured cusp rarely damages the pulp, and usually doesn’t cause much pain. Your dentist can place a new filling or crown over the damaged tooth to protect it.
Cracked Tooth
A cracked tooth means a crack extends from the chewing surface of your tooth vertically toward the root. The tooth is not yet separated into pieces, though the crack may gradually spread. Early diagnosis is important in order to save the tooth. If the crack has extended into the pulp, the tooth can be treated with a root canal procedure and a crown to protect the crack from spreading.
Split Tooth
A split tooth is often the result of the long-term progression of a cracked tooth. The split tooth is identified by a crack with distinct segments that can be separated. A split tooth cannot be saved intact. The position and extent of the crack, however, will determine whether any portion of the tooth can be saved. In some cases, endodontic treatment may be performed to save a portion of the tooth.
Vertical Root Fracture
Vertical root fractures are cracks that begin in the root of the tooth and extend toward the chewing surface. They often show minimal signs and symptoms and may, therefore, go unnoticed for some time. Vertical root fractures are often discovered when the surrounding bone and gum become infected. Treatment may involve extraction of the tooth. However, endodontic surgery is sometimes appropriate if a tooth can be saved by removal of the fractured portion.
Root Resorption
Root resorption- a condition of the tooth associated with either a physiologic or pathologic process resulting in a loss of dentin, cementum and/or bone. (Glossary of Endodontic Terms 2020).
Root resorption can be treated at the early stages. It can be addressed internally by performing a root canal therapy or externally by the surgical approach.
Traumatic Injuries
Traumatic dental injuries present difficult challenges for both patients and their dentists. Current evidence allows the dental health care provider to manage situations that, in the past, often resulted in crippled dentition and unsightly appearance. Appropriate treatment can turn what at first glance looks like a hopeless situation into a very satisfactory outcome for patients. The endodontic specialist can play an important role in the team approach to treating patients with traumatic dental injuries.
For more information please visit dentaltraumaguide.org.
Text, images, and video are courtesy of American Association of Endodontists (aae.org).
