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After endodontic therapy has been executed, or re-executed, successfully, and the canals can no longer provide a nutrient-rich habitat for microbes, [31] the issue of bone healing comes into focus. Ostensibly, then, for regeneration to occur, the root canal system must have been decontaminated and further access to microbial invasion must be ...
A specialist can often re-treat failing root canals, and these teeth will then heal, often years after the initial root canal procedure. [citation needed] The survival or functionality of the endodontically treated tooth is often the most important aspect of the endodontic treatment outcomes, rather than its apical healing alone. [48]
The filling promotes cementum and bone formation, [21] [22] blocks bacteria, and is a barrier for the root canal. Inflammation of the periradicular site due to bacteria could cause recovery to deteriorate and induce periradicular infection. [22] Careful evaluation of root canal filling material is required to optimise healing after the procedure.
While millions of root canal treatments are carried out in the United States alone each year, total numbers of such cases do not provide reliable indicators of frequency, even for symptomatic periapical periodontitis (given that root canal treatment is not always indicated or complied with, and may also be performed in the absence of ...
Tooth#4, the maxillary right second premolar (upper right 2nd bicuspid), after extraction. The two single-headed arrows point to the CEJ, which is the line separating the crown (in this case, heavily decayed) and the roots. The double headed arrow (bottom right) shows the extent of the abscess that surrounds the apex of the palatal root.
Risk of occurrence of a phoenix abscess is minimised by correct identification and instrumentation of the entire root canal, ensuring no missed anatomy. Treatment involves repeating the endodontic treatment with improved debridement, or tooth extraction. Antibiotics might be indicated to control a spreading or systemic infection.
An unusual root canal shape, complex branching (especially the existence of horizontal branches), and multiple root canals are considered as the main causes of root canal treatment failures. (e.g. If a secondary root canal goes unnoticed by the dentist and is not cleaned and sealed, it will remain infected, causing the root canal therapy to fail).
Removal of the necrotic pulp and the inflamed tissue as well as proper sealing of the canals and an appropriately fitting crown will allow the tooth to heal under uninfected conditions. [2] Surgical options for previously treated teeth that would not benefit from root canal therapy include cystectomy [12] and cystostomy. [12]