Dental Implants | Esthetic Dentistry
Periodontology | Dr. George Makris & Co.

When and why do I need a root canal treatment?

The main cause of root canal treatment is bacteria! The most common cases that require root canal treatment are the following:

1. When a cavity approaches or has reached the nerve of the tooth and infects it, it must be removed because it either causes severe symptoms or eventually dies.
2. When the nerve is dead and the tooth’s canals are infected by bacteria. If the dead nerve is not removed, there is a risk that the infection will spread to the bone surrounding the tooth and create a cyst.
3. When placing a prosthetic restoration requires the root canal treatment of the teeth supporting it.
4. When a tooth breaks and the nerve is exposed to the oral environment, it gets infected by bacteria and becomes inflamed.

What is a root canal treatment?

Root canal treatment, or scientifically known as endodontic therapy, is the process by which we remove the nerve of the tooth (alive or dead), clean the canals where it was located, and then fill the space with a material to hermetically seal it, so that bacteria cannot grow again.

Will I feel pain during the root canal treatment?

The pain during root canal treatment is a myth that is now a thing of the past! The entire procedure is done completely painlessly using advanced local anesthesia techniques!

How many visits are needed to complete a root canal treatment?

Depending on the findings, it can be completed in one session or, less frequently, in a second session. Multiple visits and changes pose a greater risk than success.

I had a root canal treatment in the past, but it failed. Why might this happen?

Again, the answer is… bacteria! Failure of a root canal treatment means that the bacteria inside the roots of the tooth were not eliminated during the previous treatment and multiplied again, causing symptoms (pain/swelling). Another reason could be re-contamination due to technical reasons after the endodontic treatment (for example: improper restoration of the tooth (aggressive axles, pins, cracks, fractures of the tooth or its roots, reappearance of decay in the tooth), etc.

What does redoing a root canal treatment mean?

When a tooth with an old root canal treatment shows symptoms, it must be re-treated, meaning it should be cleaned internally again to eliminate bacteria! This involves removing the old materials, cleaning the tooth’s canals, and placing new material to the correct length and thickness in order to hermetically seal the roots so that bacteria cannot grow again. If the endodontist considers that re-treatment threatens the tooth, they may suggest apicoectomy (a microsurgical technique).

What is apicoectomy / microsurgical technique?

When a previously treated tooth shows symptoms, but the endodontist deems it technically impossible to re-treat or if re-treatment threatens the integrity of the tooth or its exact prosthetic restoration (zirconia, all-ceramic, etc.), an apicoectomy may be performed. This is a microsurgical technique in which the clinician gains direct access to the bacterial area at the root tip by opening the gums, cleans the area thoroughly, removes a small part of the root tip, and seals the remaining part hermetically with bioceramic. Then, the gums are repositioned. This technique is performed using a microscope and may also be a solution in cases where the patient does not want the prosthetic restoration of the tooth to be damaged or when re-treatment has already been done, but symptoms persist.

Does apicoectomy hurt?

As mentioned above for endodontic treatment (root canal), apicoectomy is also performed using advanced local anesthesia techniques, making it a completely painless procedure for the patient.

Root canal or implant?

At our clinic, the priority is to save natural teeth using new techniques and materials to restore them. If saving a tooth is impossible or unsuccessful, the only solution is extraction. In this case, placing an implant to restore the gap is ideal. The decision is always made through discussion with the patient and collaboration with colleagues from various specialties in the clinic.

Cases

Microsurgical technique (apicoectomy)

Endodontic treatment (root canal) due to pulp (nerve) necrosis

Repetition of endodontic treatment

*The black area at the tip of the root (arrow) shows the extent of bone destruction. After six months, there is complete healing. The black area has been filled with new bone. This differentiation in the check-up after 6 months serves as the criterion for considering an endodontic or microsurgical treatment successful.