Root Canal

If you are experiencing tooth pain or any other symptoms of a root canal infection, call one of our three Triangle-area dentist offices today to set up a consultation. We will discuss whether a root canal is right for you and answer your questions about the root canal procedure.

I decided to use oraqix because the patient had a few pockets depths between 6-7 mm, and was very sensitive during the power instrumentation. It helped me to effectively remove the plaque and the calculus from the pockets with the hand instruments, but I found that it was not as effective when I used the Cavitron. After the removal of plaque and calculus I reviewed OHI with my patient Evelyn and reinforced the proper use of dental floss and have the patient practice in her mouth. During the afternoon section, I worked on the mandibular arch and as before I started with the power instrumentation. However, I was not able to use it in all the mandibular teeth because some of them had recession, and the patient was extra-sensitive. The good thing was the mandibular arch had only one area with 6-7 mm of pocket depth. I also used Oraqix in this area, but did not help with the recession because the pain was related to the pulp and not to the gingiva, in where Oraqix works. After finishing with debridement, my patient expressed having pain on the distal surface of tooth # 17. We decided to take a PA of the area because that part of the tooth was not visible in the HBW I

The vast majority of root canal treatments are successful the first time through. However, a small percentage of people who have a root canal done will need to the that same tooth treated again at some point down the road. The causes behind a retreatment can vary, but are generally caused by one of the following issues:

Root canal therapy is designed to be a simple, pain-free procedure to help eliminate discomfort caused by infection. We use topical and local anesthetics to numb the tooth and connected nerve before beginning the procedure. We also offer sedation dentistry to those who need a little extra help feeling at ease. The two types we offer are nitrous oxide and oral conscious sedation. Learn more about how we can provide you with pain-free, stress-free dentistry here.

The Incidence of post Obturation pain is effecting clinical decision. The lower incidence of post Obturation pain is usually the treatment of choice. Even with or against one-visit root canal treatment.

Clinically, root caries appears as a soft, irregularly shaped lesion, either totally confined to the root surface or also involving the enamel at the cemento-enamel junction. (Flaitz) It is more easily detected on exposed root surfaces. It has been found that 10% to 20% of root caries lesions are found subgingivally, especially at the interproximal region. The most common locations also include exposed roots of the mandibular premolar and molar areas. On a dental radiograph, root surface caries appears as a cupped-out or crater-shaped radiolucency just below the cemento-enamel junction. Early lesions may be difficult to detect on a dental radiograph.(Hassan)

Endodontic irrigation is an essential part of root canal debridement because it allows for cleaning beyond what might be achieved by root canal instrumentation alone . Few of the most commonly used irrigants are Sodium hypochlorite (NaOCl), Chlorhexidine (CHX) and Ethylenediaminetetraacetic acid (EDTA) NaOCl is the most commonly used irrigating solution because of its tissue-dissolving capability, broad antimicrobial action and its ability to neutralize bacterial toxic products . CHX is a broad-spectrum antimicrobial agent that disrupts the cell membrane of microbes . When used as a root canal irrigant and intracanal medicament, it possesses antibacterial efficacy comparable to that of NaOCl . EDTA is a polyprotic acid whose sodium salts

History of Chief Complaint: 57-year-old Caucasian female presented to the Oklahoma Health Sciences Center reporting a history of severe jaw pain. The patient stated that the pain began about four months ago. Initially, the pain would come and go, but Ms. Winters stated that “here lately the pain seems to be continuous”. The patient described her pain as a dull ache and stated that it does not radiate. On a scale of 1-10, she rated the pain as an 8/10 when her jaw is stagnant, but stated that the pain can increase to a 10/10 when she is chewing. Tylenol (500mg) does seem to reduce the pain. Ms. Winters has not noticed any other symptoms associated with her jaw pain.

Orofacial pain can affect people in a variety of ways; from minimal pain in which the person can function normally throughout the day, to severe pain in which they need medical assistance. Dental pain is the number one cause of orofacial pain, but in some instances, is not always the source of the pain. The typical ‘misdiagnosis’ happens when a patient complains of tooth pain, a root canal is performed, and the patient still has pain. The pain itself may actually be originating from a number of sources giving a differential diagnosis including but not limited to: myofascial toothache, sinusitis, migraines, and oral cancer (Balasubramaniam, 2011).

Bonding or fillings can be used to treat small to medium cavities. Severe damage is restored with a dental crown. If there is dental pulp infection, endodontic therapy, or root canal therapy, is performed to remove the dead pulp and bacteria. The root canals and the pulp chamber are sealed off, and the tooth is capped with a crown. If you are prone to cavities, Dr. Das may recommend special mouthwash, fluoride treatment, and sealants for extra protection. You may also need to visit us more frequently for cleaning appointments.

Clinical endodontic procedures rely on mechanical instrumentation and intracanal irrigants and medications to disinfect the root canal system. Although current instrumentation techniques involving hand and/or rotary instruments as well as ultrasonic and sonic devices can greatly reduce the bacterial load in the infected

Their case study determined that 50% of individuals with oral piercings had to seek consultation for discomfort in the oral cavity. Acute complications may occur immediately like pain, swelling, hemorrhage, and local infection. Postoperative complications include, dysphonia (complication in speech), dysphagia (difficulty or discomfort in swallowing), problems with mastication, and the existence of galvanic currents (two metals hit and sending electrical shock to individual). Chronic complexities of oral piercings include postoperative hemorrhage, hyperplastic tissue, widening of the piercing hole, chemical burns from aftercare, paresthesia (abnormal tingling or prickling sensation), sialadenitis (inflamed salivary glands), and scar tissue formation. Trauma may also occur on both the hard and soft tissues. The constant biting of a tongue piercing against the incisal and occlusal surfaces of the teeth may cause trauma to the enamel, dentin, and in some cases, the pulp. Gingival recession is a common repercussion to tongue piercings. Although it may not appear instantly, recession on the lingual surfaces of the anterior teeth occur at least 2 years after the initial piercing. Gingival recession is irreversible and may cause serious attachment loss to the teeth.

Anatomic variation in root and root canals may pose a diagnostic and therapeutic challenge to the endodontist. Incomplete removal of pathogens from incompletely treated or untreated root canals is the principle cause of periradicular pathosis13. For complete shaping and cleaning of all the canals, clinicians should be familiar with the anatomy of the teeth and their associated variations.

An ideal orthograde or retrograde filling material should maintain a hermetic seal in the pathway of communication between the root canal and its surrounding tissues (Parirokh et al., 2010). It should be biocompatible, dimensionally stable, exhibit favourable host tissue response, insoluble in tissue fluids, nontoxic, non-carcinogenic and radiopaque (Parirokh et al., 2010; Kratchman et al., 2004)

Irrigation stands on top of the various procedures followed during root canal therapy; evidence supports that significant portions of root canals harbouring the endodontic biofilm remain undisturbed even after thorough mechanical preparation, thus emphasizing the critical importance of irrigation in endodontic practise. As discussed earlier combination of various irrigants either simultaneously or sequentially are essential to eradicate the endodontic biofilm. A huge array of irrigants have been used in endodontic practise, yet sodium hypochlorite owing to its characteristic properties like pulp dissolution and antibacterial properties still remains the most commonly used and the most effective agent for irrigation of root canals. Also sodium hypochlorite is responsible for removal of organic portion of the smear layer. Ethylene diamine tetra acetic acid is yet another commonly used irrigant in endodontic practise and one of most reliable agent for eradication of smear layer. Chlorhexidine digluconate known for its sustained antimicrobial action is commonly used as intracanal medicament as well as irrigating solution. Its affectivity against E. faecalis makes it the irrigant of choice in retreatment and root canal failure cases. Hydrogen peroxide, iodine compounds, organic acid like citric acid, maleic acid, normal saline and water are few amongst the various synthetic agent used for irrigation in endodontics. Sequential use of sodium hypochlorite followed by EDTA as a final