Framingham Cosmetic Dentistry - Endodontics

Dr. Madani, an expert technician of these complicated procedures handles many such cases on a weekly basis. Although there are several variations and areas of difficulty in treatment and diagnostics of this oral disorder, you can look forward to receiving the very best care with Dr. Madani.

What is Endodontics?

Endodontics is the area of dentistry dealing with the prevention, diagnosis, and treatment of disorders of the dental pulp.

Endodontic therapy (root canal) is a treatment modality that will save diseased or injured teeth. The alternative to endodontics is extraction. Typically, a severely decayed tooth or a tooth with a large filling will begin to ache. The pain might be intermittent at first and over time progress to a constant dull throbbing pain or a severe ache that might be felt on all the teeth on the affected side. Sometimes there is no pain and an abscess might be discovered on a routine x-ray.

The pulp is the soft tissue that is located inside the tooth structure. It contains nerves, arteries, veins, and lymph tissue. It is contained in the canals located in thin tube-like spaces in the roots and in the pulp chamber located within the crown of the tooth.

When the pulp is diseased or injured and unable to repair itself, it becomes infected. Left untreated, the pulp will die and become necrotic. Pus can build up at the root tip, forming an abscess that can destroy the bone surrounding the tooth. Endodontic treatment is the removal of the diseased pulp tissue.

The most common reasons a tooth develops infections are:

• Dental decay (large deep cavities)
• Accumulative effects of placing several filling over time
• Restorative insults to teeth (drilling, heat and desiccation)
• Traumatic injury (accident)

Endodontic therapy normally takes two or three visits to complete.

The following steps are involved in the treatment of the tooth:

A local anesthetic is used so the procedure will be pain free. The tooth will then be isolated by placing a rubber dam over it. This thin sheet of rubber provides a clean and aseptic working environment.

An opening is then made through the top of the tooth into the pulp chamber.

The pulp is removed from the pulp chamber and the root canals are cleaned, enlarged, and shaped to a form that can be filled and sealed latter. A temporary filling is placed in the the opening in the tooth to seal it between visits. There can be some discomfort in the area of the tooth for a day or two.

During the next stage of treatment, the temporary filling is removed & the root canals are filled & sealed. Once the process is completed, the tooth will need to be restored. The normal subsequent treatment is usually a Crown, because the decay and lost structure leaves the tooth vulnerable. Additionally patients may require a post in the root to provide additional support for the tooth's Structure.

Endodontic Microsurgery

Endodontic microsurgery is required when there is a complication, such as an endodontic abscess, that cannot be corrected by a retreatment. Usually and x-ray will identify that a blockage exists in the canal which is preventing access, treatment and correction of the problem which can only be accessed by treating the root tips directly. During surgery, the root end is identified and a small amount of it is shaved off. Usually the root end is then prepared and filling is placed to seal the canal and prevent leakage and contamination.