Types of Root Canals

"Root canal:" the words themselves are enough to set one's teeth on edge, conjuring images of discomfort from an invasive procedure, followed by painful recovery. Everyone has heard the saying, "I'd rather have a root canal than ..." Root canal treatment is the main procedure the field of endodontics, the specialty in dentistry concerned with diseases of tooth pulp and tissue.

Types

• There are basically two types of endodontic treatments. One is the regular root-canal therapy, which takes place when the pulp inside a root canal system becomes infected. The second type of procedure, known as an apicoectomy, is often necessary when a patient who received a first root canal needs a second treatment because of new trauma or deep decay that causes new infection.

Root Canal Therapy

• Most root-canal treatments require no more than two visits to an endodontist. During the treatment, the endodontist numbs the infected tooth with anesthetic, then opens the crown of the tooth. Opening the crown provides access to the root canal system and the pulp chamber. The endodontist removes the diseased pulp, then cleans and shapes the root canal for filling. Cleaning and shaping is an important step in the root canal treatment. After the canal is cleaned and shaped, the endodontist fills the root canal with gutta-percha, a biocompatible rubber-like material. After filling, the endodontist seals the canal before placing a temporary filling to close the affected tooth. A permanent crown is placed later, usually by the patient's regular dentist.

Apicoectomy

• Because of the complexity of root-canal systems, it is possible for infected pulp to remain in the system. In other cases, deep decay or some new trauma can lead to new infection, requiring additional endodontic care. In these instances, patients may need to undergo a second root canal. In other cases, however, the endodontist may perform an apicoectomy. This operation may occur if a second root canal treatment is unsuccessful or cannot be done.
  This procedure involves removing the tip of the tooth root, along with the new infected tissue. Because this procedure involves the use of an operating microscope, an apicoectomy is sometimes referred to as endodontic microsurgery.

After the Operation

• Patients who undergo an apicoectomy may experience pain and swelling after the operation. Pain can generally be managed with over-the-counter medications. Swelling and pain is usually gone within two weeks.

Considerations

• Despite its reputation, root-canal therapy is not so painful, thanks to advances in dental technology and anesthesia. Technological advances have made it easier for dentists to detect root canals that need treatment or did not receive sufficient attention. Most patients, in fact, have indicated that they were generally comfortable during their root-canal treatments.