MICROSCOPIC ENDODONTICS

WHAT WE DO BEST

1) RETREATMENT OF ROOT CANAL THERAPY:

In many cases the tooth may not heal as expected after an initial root canal therapy. This could happen for a variety of reasons: narrow or curved canals were not sufficiently treated during the initial treatment, complicated canal anatomy went undetected in the  initial treatment, the restoration did not prevent salivary contamination to the inside of the tooth. In other cases, a new problem can jeopardize a tooth that was successfully treated. For example: new decay can expose the root canal filling material to bacteria, causing a new infection in the tooth, loose, cracked or broken crown or filling can expose the tooth to new infection, or tooth sustains a fracture. 
In these cases, we most often recommend a retreatment of the initial root canal therapy. The tooth will be reopened to gain access to the root canal filling material. In many cases, complex restorative materials—crown, post and core material—must be disassembled and removed to permit access to the root canals. After removing the canal filling, the canals should be cleaned and carefully examined using magnification and illumination, searching for any additional canals or unusual anatomy that requires treatment.After cleaning the canals, the canals will be filled and sealed  and a filling will be placed in the tooth. If the canals are unusually narrow or blocked,  endodontic surgery may be recommended. This surgery involves making an incision to allow the other end of the root to be sealed (Further information could be found on the website of the American Association of Endodontists).

2) VITAL PULP THERAPY IN ADULTS:

Vital pulp therapies (VPTs) aim to preserve the vitality of the pulp. We lay great emphysis on VPTs in order to keep the pulp of the tooth vital for as long as possible. By such,  we could maintain the vitality of the root pulp after opening the crown pulp even following crown fracture or deep cavities. The option is highly recommended by the American and the European associations of endodontics for milk teeth in order to preserve them as space-maintainers, and for permanent teeth especially when the growth of their root is not yet fully completed, in order to allow a complete formation of the root tip.

3) REMOVAL OF BROCKEN INSTRUMENTS:

Instrument fracture during root canal therapy is a troublesome incident that can interfere with efficient cleaning and shaping of the root canal or act as an irritant to the periapical tissues especially when some part of the separated fragment over extends from the root apex. The most common causes of instrument separation include improper or excessive use, inherent physical properties, inadequate access, root canal anatomy and possible manufacturing defects. The prognosis of endodontic treatment of a tooth with a broken instrument in the canal, depends on the stage of instrumentation prior to instrument separation, pretreatment pulpal or periradicular tissue status and whether or not the fractured file can be removed or bypassed.

Every attempt should be made for removing the fragment or bypassing it followed by adequate cleaning and shaping and incorporating it into the final canal obturation. In this procedure, adequate magnification, illumination and proper isolation are the key to success. Sometimes surgery may be needed to remove the broken file and some part of the root that cannot be cleaned because of obstruction created by the broken fragment. 

4) MANAGEMENT OF DENTAL TRAUMA IN ADULTS:

Traumatic dental injuries often occur as a result of an accident or sports injury. The majority of these injuries are minor - chipped teeth. It’s less common to dislodge your tooth or have it knocked completely out but these injuries are more severe. Treatment depends on the type, location and severity of each injury. Regardless of the extent of the injury, the affected tooth requires immediate examination by a dentist or an endodontist. Sometimes, the neighboring teeth suffer an additional, unnoticed injury that can only be detected by a thorough dental exam.
We are specialized in treating traumatic dental injuries. With advanced skills, techniques and technologies we often can save injured teeth (Further information could be found on the website of the American Association of Endodontists).