At Justendo@thecastleclinic we treat the most COMPLEX cases that require either Facial Pain Diagnosis, Primary Root Canal Treatments, Re-Root canal treatment (Revision) and Apical Microsurgery. The success rates are very high and comparable to dental implants, therefore removal of the tooth and implant placement should be the LAST resort.
All patients will be given an idea of the potential prognosis or success rates. This will also include ALTERNATIVE options where the prognosis indicates a potentially better outcome with another treatment
The academic quoted success rates are as follows;
Root Canal Treatment 88-97% (with infection 74-91%)
Re- Treatment 93-97% ( with infection approx. 85%)
Apicectomy (Old Fashioned treatment ) 44-70%
Apical Microsurgery with retreatment 85-95%
Why Do Root Canal Treatments FAIL
Endodontic treatment can fail for a number of reasons: It was not possible to treat narrow or curved canals well enough or the canals were not fully cleaned during the initial procedure. The tooth may have additional complicated anatomy that was not found on the initial treatment. It may also be due to undiagnosed fracture or fractured instruments. Microscopes and CBCT are more likely to be able to aid the clinician in diagnosis as well as treatment feasibility.
The final restoration was not placed quickly enough or the final restoration leaked due to a poor fit, fracture or recurrent decay around it.
So What Happens During Root Treatment?
Endodontic treatment usually can be completed in one appointment, depending on the condition of your tooth and your personal circumstances. We use local anaesthesia in your tooth area and only start the treatment when we are sure you are fully numb and will test the tooth prior to any intervention.
A non-latex protective shield called dental rubber dam is placed to isolate your tooth to keep it clean and dry during the procedure, avoiding further contamination, as well as protecting your airway. This also stops water from drills filling the mouth up with fluids that patients often find problematic. Breathing through your nose and the space provided should allow you to be comfortable throughout the treatment.
AT ANY TIME, if your have either a bad taste, are filling up with saliva or are worried, we ask that you raise your LEFT hand and we will stop and address any issue.
An opening in the crown is made and we locate the canals, remove the infected dental pulp, clean, shape and disinfect the canals.
Using a Dental Operating Microscope, we are better able to identify pulp stones blocking the canal access, identify all of the nerve canals, look for fractures within the tooth or to aid removal of broken instruments.
The tooth is cleaned with a mixture of endodontic instruments (files), chemical debridement and dissolution of necrotic debris with Sodium Hypochlorite and Etidronic acid. We also have the use of Ultrasonic Irrigation, specially developed mechanical debridement instruments as well as other techniques.
The canals are then filled with a biocompatible material and a permanent filling is placed over the access opening to protect your roots from being exposed or contaminated until you return to your general dentist for your final restoration.