ROOT CANAL TREATMENT

At Hilltop Dental Wellness, Dr. Apelian renders root canal treatments on all teeth from anteriors to molars. Utilizing magnification of telescopic lenses and using the latest materials allows proper location and treatment of fine canals that helps preserve the longevity of patient’s teeth.  Occasionally, Dr. Apelian also provides retreatment of previously performed root canal treatment.

Introduction

Each tooth of the oral cavity has a living environment in a compartment known as “pulp tissue”. (Enamel is the only component of the tooth that is not alive). The pulp tissue undergoes inflammatory changes. This results to edema (increase of inter pulpal pressure) with pain and disruption of the homeostasis of the pulpal environment. At times, the pulps inflammation will reverse itself and the sensitive tooth will feel normal again. Younger individuals usually have a wide-open pulp chamber and canals, which facilitate better blood flow and quicker healing. This is why these younger teeth have better chances of reversing there inter pulpal inflammation. An older pulp, however, is usually more constricted and even more calcified. This will result in less blood flow and less chances for the pulp to heal its inflammation.

The persistently inflamed pulp may or may not exhibit any symptoms. It will eventually develop into a dead pulp (necrotic). Given more time, the necrotic pulpal tissue will cause a pulpo-periapical abscess at the apex (tip) of the root; this is why root canal treatments are desired to be performed on teeth with pulpal tissues that are still alive but not completely necrotic.

Causes of Pulpal Inflammation & Root Canals

There is no definite and final 100% cure of this condition. These are the basic means of preventing and treating periodontal diseases:

  • Deep microbes (bacteria) of the dental caries penetrate into the pulp via the dental tubules.
  • Traumatic biting, it has been said that severe clenching/bruxing is the mother of all dental diseases.ng/br
  • Traumatic injuries (falls, accidents, sport related facial trauma) may result to a necrotic pulp. Maxillary incisors are most common.
  • Periodontal bone loss and exposed roots.
  • Rapid orthodontic tooth movements.

Classification of Root Canals

  • Vital Teeth with symptoms - The root canal candidate tooth is very sensitive to temperature (hot/cold).
  • Non-Vital Teeth, without symptoms - Teeth are not usually very sensitive to hot and cold and the irreversible inflammation is confined within the pulp chamber.
  • Non-Vital teeth, with symptoms – Necrotic (non-vital) pulps may eventually develop an apical chronic abscess (apical periodontitis). These chronic abscesses if remain undetected eventually will develop into acute abscesses. Suppuration (puss) will drain the underlying puss via an opening through the gingival mucosa, through a blister appearing opening known as fistulae. These apical abscesses are safe heavens in harboring pathogenic microorganisms. They have direct access to the individual’s main blood stream, to the heart valves, vessels and to the cerebral (brain) circulation. Occasionally, a conventional root canal does not clear the chronic apical lesion (abscess granuloma or a cyst). Surgical intervention is required to enucleate the apical lesion. The procedure is known as Apicoectomy. It is always recommended that Root Canal treatments to be rendered on teeth while the pulpal tissue has not become chronically necrotic.

Treatment Sequence

  • The anesthetized tooth requires a “cleansing and shaping” visit to clean out the contents of the pulpal chamber and shape the canals that later are to be filled.
  • Obliteration (sealing/filling) of the canals with some inert rubber material (gutta percha) is most common.
  • Restorative Phase to restore the endodontically treated tooth (may or may not require a post and or a crown).
  • Periodic follow ups and x-rays.

ROOT CANAL TREATMENT

At Hilltop Dental, Dr. Apelian renders root canal treatments on all teeth from anteriors to molars. Utilizing magnification of telescopic lenses and using the latest materials allows proper location and treatment of fine canals that helps preserve the longevity of patient’s teeth.  Occasionally, Dr. Apelian also provides retreatment of previously performed root canal treatment.

Introduction

Each tooth of the oral cavity has a living environment in a compartment known as “pulp tissue”. (Enamel is the only component of the tooth that is not alive). The pulp tissue undergoes inflammatory changes. This results to edema (increase of inter pulpal pressure) with pain and disruption of the homeostasis of the pulpal environment. At times, the pulps inflammation will reverse itself and the sensitive tooth will feel normal again. Younger individuals usually have a wide-open pulp chamber and canals, which facilitate better blood flow and quicker healing. This is why these younger teeth have better chances of reversing there inter pulpal inflammation. An older pulp, however, is usually more constricted and even more calcified. This will result in less blood flow and less chances for the pulp to heal its inflammation.

The persistently inflamed pulp may or may not exhibit any symptoms. It will eventually develop into a dead pulp (necrotic). Given more time, the necrotic pulpal tissue will cause a pulpo-periapical abscess at the apex (tip) of the root; this is why root canal treatments are desired to be performed on teeth with pulpal tissues that are still alive but not completely necrotic.

Causes of Pulpal Inflammation & Root Canals

There is no definite and final 100% cure of this condition. These are the basic means of preventing and treating periodontal diseases:

  • Deep microbes (bacteria) of the dental caries penetrate into the pulp via the dental tubules.
  • Traumatic biting, it has been said that severe clenching/bruxing is the mother of all dental diseases.ng/br
  • Traumatic injuries (falls, accidents, sport related facial trauma) may result to a necrotic pulp. Maxillary incisors are most common.
  • Periodontal bone loss and exposed roots.
  • Rapid orthodontic tooth movements.

Classification of Root Canals

  • Vital Teeth with symptoms - The root canal candidate tooth is very sensitive to temperature (hot/cold).
  • Non-Vital Teeth, without symptoms - Teeth are not usually very sensitive to hot and cold and the irreversible inflammation is confined within the pulp chamber.
  • Non-Vital teeth, with symptoms – Necrotic (non-vital) pulps may eventually develop an apical chronic abscess (apical periodontitis). These chronic abscesses if remain undetected eventually will develop into acute abscesses. Suppuration (puss) will drain the underlying puss via an opening through the gingival mucosa, through a blister appearing opening known as fistulae. These apical abscesses are safe heavens in harboring pathogenic microorganisms. They have direct access to the individual’s main blood stream, to the heart valves, vessels and to the cerebral (brain) circulation. Occasionally, a conventional root canal does not clear the chronic apical lesion (abscess granuloma or a cyst). Surgical intervention is required to enucleate the apical lesion. The procedure is known as Apicoectomy. It is always recommended that Root Canal treatments to be rendered on teeth while the pulpal tissue has not become chronically necrotic.

Treatment Sequence

  • The anesthetized tooth requires a “cleansing and shaping” visit to clean out the contents of the pulpal chamber and shape the canals that later are to be filled.
  • Obliteration (sealing/filling) of the canals with some inert rubber material (gutta percha) is most common.
  • Restorative Phase to restore the endodontically treated tooth (may or may not require a post and or a crown).
  • Periodic follow ups and x-rays.

HILLTOP DENTAL WELLNESS

HILLTOP DENTAL WELLNESS

30300 Agoura Road
Suite 230
Agoura Hills, CA 91301
Phone: 818-865-8651   ♦   Fax: 818-865-8647