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What
Is Non-Surgical Root Canal Treatment (NSRCT)?
Non-surgical root canal treatment is a procedure directed
towards saving an endodontically failing tooth. At times,
the patient's existing artificial crown must be removed. In
other instances, access through the crown may be possible.
The access opening is created in order to give the dentist
non-surgical access into the root canal space through the
biting surface of the tooth. Once this has been accomplished,
a non-surgical retreatment procedure oftentimes requires:
- Locating
and treating previously missed canals.
- Removing
old filling materials from the root canal space.
- Removing
posts and broken instruments.
- Enhancing
existing root canal treatment.
- Negotiating
blocked canals and bypassing canal ledges.
- Repairing
mechanical and pathological perforations in the root.
Once
these objectives have been accomplished, the root canal system
is re-cleaned, re-shaped, disinfected, and three-dimensionally
sealed. A protective restoration can then be placed and the
tooth restored to a state of health and function.
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What
Is Surgical Root Canal Treatment (SRCT)?
Surgical root canal treatment is a procedural effort in which
it is necessary to elevate a small flap of tissue adjacent
to the involved tooth in order to gain access to and treat
root canal disease. Surgical root canal treatments are usually
minor, in-office procedures performed under local anaesthesia.
Once the pathological area is exposed, the doctor performs
a "curettage" to remove the diseased tissue from
around the root. This is usually followed by an "apicoectomy,"
a procedure in which the diseased portion of the root is removed.
A small filling is then usually placed to seal the remaining
portion of the root. Surgical root canal treatment will oftentimes
result in a good long-term prognosis for the tooth if the
cause of pathology can be effectively eliminated.
Unfortunately, on occasion, retreatment efforts may not be
possible or cost-effective and extraction may be the only
alternative. However, saving a tooth that has been previously
treated endodontically and is failing is usually possible,
can be very predictable, and is typically the most conservative
option for the patient.
Today,
well-trained general dentists and specialists alike can oftentimes
perform non-surgical endodontic retreatment in a very predictable,
cost-effective, and time saving manner when compared to other
treatment alternatives. At times, however, retreatment cannot
be managed with non-surgical efforts alone. In these situations,
and as an alternative to extraction, a surgical approach may
be necessary.
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Alternatives
to Root Canal Treatment - The only alternative to root
canal treatment is the extraction of the problematic tooth.
It is wise to consider all of the implications of losing a
tooth before having it removed. The decision should not be
made hastily or because the tooth is painful. If pain is present
and the dentist thinks that the tooth can be saved, the discomfort
can first be relieved and then the alternatives explored.
The
discussion about tooth replacement alternatives after extraction
can be complex because each individual situation is unique
and, at times, various specialists may need to be consulted.
When considering the alternatives for replacing a missing
tooth, a few of the major factors to consider are the long-term
predictabilities of the various alternatives, the overall
chair time involved in treatment, the esthetic results, the
effects on the adjacent and opposing teeth, and the costs.
The usual alternatives that a patient has after tooth extraction
are:
- A
restored dental implant. This restoration involves
a surgical procedure to insert the dental implant into
the bone, a healing phase of several months, and a final
restorative phase, which is similar to having a single
tooth crown. Significant time and laboratory costs are
involved.
- A
fixed bridge. Fabricating a fixed bridge requires
cutting down ("preparing") the teeth next to
the missing tooth so that they can receive the artificial
crowns that support the replacement tooth. These teeth
must be strong and healthy if they are to be effective
bridge supports. Preparing the teeth for crowns could
have a detrimental effect on their pulp health, depending
on a variety of factors. This possibility needs to be
discussed and factored into your decision. Fixed bridges
may take multiple appointments to complete and have significant
associated costs.
- A
removable partial denture. These appliances restore
function and esthetics and can be inserted into the mouth
and removed at will. Although many teeth are successfully
replaced with removable prosthetic appliances, patients
may initially find them cumbersome. Removable partial
dentures may also temporarily alter phonetics as well
as place unfavourable forces on the supporting teeth and
soft tissues. There may be significant costs associated
with this restoration.
- Not
replacing the extracted tooth. This is a poor
choice in most situations. Leaving a space after extraction
can lead to long-term problems with teeth shifting and
tipping, destabilization of the biting system, and esthetic
changes in the profile of the face. Financially and psychologically,
this could turn out to be the most costly choice over
the lifetime of the patient.
After
considering and weighing all of the consequences of extraction
and all of the alternatives for tooth replacement, in most
situations it becomes obvious that well-performed root canal
treatment with a protective restoration is the treatment of
choice. Root canal treatment is usually the least time-consuming,
the least invasive, and Ortho.
| Inlays
/ Onlays |
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| These
are restorations that can replace missing or broken tooth
structure when a filling just won't be strong enough.
These restorations can be made of tooth colored ceramics
(porcelains), composites or polyglass materials (plastics
with fillers such as quartz, fiber, or glasses). |
| Porcelain
Crowns |
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| Porcelain
crowns are another restorative dentistry procedure that
can be used for correcting teeth defect. Sometimes teeth
become too unstable for repairing. This is when porcelain
crowns can be used for correcting the condition. Here
the entire outside portion of the teeth is covered up
with porcelain veneers to help you in getting back the
perfect teeth. |
| Implants |
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| Implants
are a restorative dentistry procedure that can be used
for replacing missing teeth. In this procedure titanium
roots are placed in the jawbone of missing teeth. The
jawbone must be strong enough to support new growth of
teeth. The roots can be used for building a single tooth
or a set of teeth as may be needed for filling up the
gap in a person’s mouth. |
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