Root Canals | Root Canal Re-treatment | Cracked Tooth | Apical Surgery | Bone Grafting

The root canal is one of the most common dental procedures performed by Portland Endodontists; more than 14 million performed by Endodontists each year with over a 95% success rate. This simple procedure can save your natural teeth and prevent the need for dental implants and bridges down the road.

A root canal is a specialized treatment used to save cracked teeth that are damaged or diseased due to a deep cavity or traumatic injury to the dental pulp. The pulp is the soft tissue at the center of the tooth which contains the blood vessels, nerves, and connective tissue. If the infected pulp is left untreated, an abscess may form at the end of the root, which can cause severe pain and swelling. The infection can also spread and damage surrounding bone and lead to possible tooth loss.

The procedure involves the removal of the damaged pulp from the root canal system. Once the pulp is removed, the canals are cleaned, disinfected, and sealed.

After a root canal procedure is completed, a crown may be required to protect the tooth from fracturing.

Most Maine Endodontists treatment usually requires one visit and takes anywhere from 30 to 70 minutes to complete under local anesthesia. We do offer IV sedation if it is desired, however a consult is required prior to treatment for any sedation.

Root Canal Re-treatment

There is about a 5% chance that a RCT will fail, meaning that the tooth will become re-infected. When this happens the RCT can be re-treated. This procedure entails removing the existing filling in the canals and starting the process over again.

Teeth are exposed to crack inducing habits everyday. Clenching, grinding, and chewing on hard objects can result in cracks and fractures in teeth. Since cracks and fractures seldom show up on x-rays, cracked and fractured teeth can be difficult to locate. Cracked teeth exhibit a variety of symptoms, including erratic pain when chewing, releasing biting pressure, and exposure to extreme temperatures.

Types of Cracks

	Craze Lines Craze lines are tiny cracks in the outer enamel of the tooth. These cracks are most commonly found in adult teeth. Since the cracks are only superficial, appearaance is the only concern.
	Fractured Cusp Occasionally the cusp becomes weakened, resulting in a fracture. The fractured cusp may break off or may be removed by a dentist. A fractured cusp rarely damages the pulp, so a root canal is seldom needed. The dentist usually restores the tooth with a full crown.
	Cracked Tooth This type of crack originates from the chewing surface of the tooth and extends down vertically towards the root. Since damage to the pulp is common, a root canal procedure is usually necessary. Occasionally the crack may extend below the gum line, requiring extraction. Early detection of the crack is essential, for if left untreated, tooth loss may occur.
	Split Tooth A split tooth is the result of untreated cracked tooth. Unlike a cracked tooth, a split tooth has distinct segments that can be separated, and cannot be saved intact. Whether or not portions of the tooth can be saved is determined by the position and extent of the crack. Although rare, endodontic treatment and restoration can save portions of the tooth.
	Vertical Root Fracture Vertical root fractures begin at the root of the tooth and extend towards the chewing surface. Unfortunately, symptoms are hard to detect and the fracture may go unnoticed for some time. Treatment options include extraction of the tooth, and in some cases, endodontic treatment if portions of the tooth can be saved.

Apical Surgery (Apicoectomy)

If a root canal fails, there are several options available. In many cases, the root canal can be retreated. However, when access to the root apices, or root tips, is not possible using conventional root canal treatment, a procedure called an apicoectomy can be preformed. An apicoectomy is the removal of the root tip and surrounding infected tissue of an abscessed tooth.

An incision is made in the gum tissue to expose the bone and inflamed tissue. The infected tissue is removed, along with the end of the root tip. A root-end filling is placed to seal the end of the root and to prevent further infection, and the gum is sutured. The bone heals over the root in a few months, and full function is restored.

Bone Grafting

Bone Grafting is a surgical procedure in which new bone is grown to replace the missing bone needed to support implants. After tooth loss occurs, over time the jawbone around the missing tooth atrophies or is reabsorbed. The bone is left in a condition unsuitable for the insertion of dental implants. This procedure gives the opportunity to use implants of the proper length and width, and to restore esthetics and functionality.