Christchurch Endodontic Practice is a specialist dental practice registered with The Dental Council of New Zealand. We take referrals from General Dentists who seek expert care with the problems they face.
Generally a consultation appointment is required before treatment is started so that a discussion on possible treatment options, the likely success of any treatment, possible problems that may occur along the process, and the cost of treatment can be addressed. The following is the list of treatments offered.
The initial assessment of a tooth, including the cause of its current problem, is a very important part of any treatment. The tools we have which help in this assessment include: *Operating Microscope* Magnification of between x3 to x30 is used with a light source through the lens in a majority of cases and is critical in this fine area of dentistry. Digital photographs are taken during the assessment and during treatment so that a particular problem can be explained in detail.
Root Canal Treatment
What you see in the mouth is merely the top part of the tooth. Underneath the gums, embedded in the jaws are the roots of these teeth. Within the roots is a space called the root canal and within this the dental pulp is found. This is made of various fine nerves and blood vessels. Root Canal Treatment involves the widening and cleaning of this space to remove any inflamed or necrotic dental pulp tissue. The space is then sealed with a root filling. Sometimes the root canals are very fine, calcified or blocked.
Root Canal Retreatment
When you are referred to us, some of you would have already had Root Canal Treatment done. If that treatment has not been successful it may be due to leakage of the root filling, decay around the existing filling of the tooth, inadequate cleaning of the root canals or a missed canal. Root Canal Retreatment aims to remove the cause of the failure and resolving that issue which usually involves removing the existing restoration and root filling. Once the cause of the failure is resolved then the root canal retreatment is done.
If a part of the tooth has broken off, it might expose the inner contents of the tooth called the pulp. This part of the tooth is very sensitive and is at risk of becoming inflamed or infected. Also, for teeth that have recently had a deep fillling done the dental pulp may become inflamed as well as become very sensitive to temperature changes. Pulpotomy involves partial removal of this exposed or inflamed pulp and protection of the remaining pulp with a Bioceramic material. This is often done using the Operating Microscope.
There are cases where surgery is required to remove a persistent lesion (abscess) that has developed over time around the end of the root of the tooth. This is generally advised only if the root canal treatment has been completed to a high standard or retreatment of the root canal is not posibble due to an obstruction in the tooth. The procedure involves making the area numb with an anaesthetic, the gum will be raised to access the end of the root.
There are three dental structures that can be damaged from dental trauma: 1. The outermost layers of the tooth, namely the enamel and dentin. These may suffer a crack or break off completely. This is usually restored by your general dentist. 2. The innermost chamber of the tooth called the pulp may also get damaged and eventually die off. A pulpotomy is required in some cases and root canal treatment in others. 3.
There are several kinds of “fillings” or restorations (as we like to call them) used in dentistry. They can be “silver fillings”-Amalgam, “white fillings”-Composite, porcelain (crowns or cerecs), Gold or a temporary material. Each of these have their own pros and cons. Usually after a root canal treatment is completed, a protective restoration is placed over your tooth. This restoration generally placed immediately, must be periodically monitored by your general dentist. A root canal treated tooth becomes weaker over time.
A dental implant is a valuable and much more convenient alternative to replace your missing teeth. This involves placing a titanium implant into the bone where the root of the tooth was. This provides anchorage for a crown up the top. Dental implant is a significant advancement in dentistry over the last 40 years. Research shows that implants placed that long ago are still functioning well and are healthy. An implant nullifies the hassle of a removable denture in the mouth giving you a higher usability, aesthetic and confidence.
Sedation is suggested for those who are very anxious when it comes to dental treatment. Midazolam is usually the agent we use and that can either be administered orally or intravenously (injection in the arm). This option relieves you of your anxiety and is safe for most people, however there is a residual affect throughout the day. It is strongly recommended that patients do not continue with their normal activity and a pick up after treatment is necessary. A careful assessment is required prior to any sedation being administered.
Sometimes it is not possible or suitable to keep a tooth and an extraction is necessary. A tooth is extracted under local anaesthetic and in some situations with added sedation. The tooth is loosened within the bone and then removed from the socket. The socket will be assessed and if necessary some stitches placed. The difficulty of extracting a tooth varies depending on the shape of the root, if the tooth has previously been root filled, if the tooth has suffered any trauma in the past and any underlying medical conditions.