Endodontics

If a tooth is repeated traumatized, or gets infected too deeply by bacteria, the nerve tissue and blood supply start to die off within the tooth. When this happens the infected and dying tissue can cause significant pain and an abscess. To treat this a root canal treatment is performed. This treatment involves removal of the dead and infected tissue and sealing of this space, usually with a rubber material and cement. Although root canal treatments are rather successful, like all things, there is a failure rate. The anatomy of teeth is so complex that in some cases diseased tissue is missed either due to difficulty in finding it, or its inaccessibility, despite the skill of the dentist. When these treatments do fail, re-treatment can often be done to find what was missed, or even surgical treatment done to seal the root tips. And in other cases, the tooth is just extracted.

Case #2 - Endodontic Re-treatment

This patient had root canal treatment done by an Endodontist (root canal specialist) about 10 years prior. Although the work that was done was good, and looked good on the x-ray, this treatment ultimately failed which was evidenced by an abscess around one of the root tips. This particular root usually has 2 channels of nerve tissue, of which one is commonly missed or very difficult to treat. Assuming this was the cause of the failure Dr. Schau performed a re-treatment. Upon opening the tooth, and with a bit of digging he found the untreated channel of nerve tissue and was able to clean it and seal it. The picture below shows the original work done with a dark spot around the root tip on the right (the abscess). The middle picture shows the final re-treatment which looks much the same as the original x-ray. The picture on the right shows the 4th channel of nerve tissue filled. The two channels in the one root are often so close together they overlap on the x-rays and appear as one unless an appropriate shift is taken with the x-ray to make them visible.

Case #1 - Endodontic Treatment

This patient had a dying tooth that was starting to cause some pain. Fortunately root canal treatment was able to be performed before a full blown abscess kicked in. The first photos show a before and after x-ray. Note how the darker lines inside the tooth (nerve channels) are filled in with with white in the after shot (radiopaque rubber material). The second picture shows the hole drilled in the top of the tooth to access the 4 channels of nerve tissue.