Dental Did You Know: The Reason you Crown Posterior Teeth that have had a Root Canal.

From the Royal College of Dental Surgeons of Ontario's PEAK article program:

In a retrospective study of uncrowned endodontically treated teeth, the overall survival rates of molars without crowns at 1, 2, and 5 years were 96%, 88% and 36% respectively.

Yikes! So no matter how conservative the access for the root canal is and the lack of any significant caries, you should crown these teeth within two years and preferably one.

Source: McComb D,  Restoration of the Endodontically Treated Tooth,  (PEAK article), Practice Enhancement and Knowledge, Supplement to Feb/Mar 2008 Dispatch. Royal College of Dental Surgeons of Ontario. 

Hans Skariah, B.Sc., DMD
Promenade Court Dental
2233 Hurontario St., Mississauga, ON, Canada (905) 273-7100
Plattsville Dental
43 Albert St. West, Unit 8, Plattsville, ON, Canada (226) 656-1000

Dental Did You Know: The Best Time After a Root Canal to Restore a Tooth

It is always better for the tooth to restore it immediately to prevent leakage of oral fluids into the root canal space. If this can not be done due to the length of the procedure or patient comfort, then a seal over the root canal area and a restoration as soon as possible is recommended.

Source: Glassman G, Bioactive Endodontic Obturation: Combining the New with the Tried and True, Oral Health, May 2014, Vol 9, No 4, pg 18-28.

Hans Skariah, B.Sc., DMD
Promenade Court Dental
2233 Hurontario St., Mississauga, ON, Canada (905) 273-7100
Plattsville Dental
43 Albert St. West, Unit 8, Plattsville, ON, Canada (226) 656-1000

Dental Did You Know: Saving Hopeless Teeth

Teeth that are mobile and periodontally involved have traditionally been extracted. However, a case report in the ODA Journal suggests that some of these teeth can be saved by a course of deep scaling, antibiotics (Amoxicillin and Metronidazole; 250 each tid for seven days) and endodontic (root canal) treatment.

Source: Tenenbaum H and Szainwald K, Saving Hopeless Teeth: Case Report, Ontario Dentist, April 2012, Vol 89, No 3, pg 23-25.

Hans Skariah, B.Sc., DMD
Promenade Court Dental Health Group in Mississauga
2233 Hurontario St., Mississauga, ON, Canada
(1/2 km north of the QEW in the Dome Building)
(905) 273-7100

Dental Did You Know: Irrigation in Root Canals

When cleaning the pulpal (nerve) area of a tooth during a root canal procedure, sodium hypochlorite (a strong base - pH 11 and more commonly known as bleach) is usually used in concentrations between 0.5 and 5.25%. The overall effect is to dissolve organic tissues that can not be readily accessed mechanically.

Source: Basrani B, Endodontic Irrigation, Oral Health, May 2011, Vol 101, No 5, pg 12-18.

Hans Skariah, B.Sc., DMD
Promenade Court Dental Health Group in Mississauga
2233 Hurontario St., Mississauga, ON, Canada
(1/2 km north of the QEW in the Dome Building)
(905) 273-7100

Nice Decision Guide for Performing Root Canals on Compromised Teeth

Saw this nice link to the American Association of Endodontists website. It's a large PDF file (4.0MB) presentation showing some of the great ways to save near hopeless teeth through endodontics and selective restorations.

You can view the presentation here: Treatment Options for the Compromised Tooth, A Decision Guide

Source: http://www.aae.org/uploadedFiles/TreatmentOptionsGuideWeb.pdf Viewed March 2, 2011

Hans Skariah, B.Sc., DMD
Promenade Court Dental Health Group in Mississauga
2233 Hurontario St., Mississauga, ON, Canada
(1/2 km north of the QEW in the Dome Building)
(905) 273-7100

Dental Did You Know: Calcium Hydroxide and Deep Fillings

Sometimes, we run into cavities that are exceptionally deep, often exposing a pinpoint area of the pulpal (nerve) area of the tooth. This often necessitates a root canal. However, we can attempt to recover and rehabilitate the tooth by capping a small exposure with calcium hydroxide, followed by a well-sealed restoration. The success levels can be quite good: a review of 14 studies have shown success rates of up to 90% with experienced clinicians.

Source: Hilton T, Keys to Clinical Success with Pulp Capping: A Review of the Literature, RCDSO Peak Publication, May/June 2010, pg 1-16.

Hans Skariah, B.Sc., DMD
Promenade Court Dental Health Group in Mississauga
2233 Hurontario St., Mississauga, ON, Canada
(1/2 km north of the QEW in the Dome Building)
(905) 273-7100

Dental Did You Know: Stem Cell and Regeneration

It may soon be possible to regenerate injured/diseased dental pulp (nerve and nutrient transport system) by using stem cells from a disposable source (i.e. baby teeth). These damaged areas are the primary reason for the need of a root canal procedure.

Source: Cordeiro M et al., Dental Pulp Engineering with Stem Cells from Exfoliated Deciduous Teeth, J Endod, Vol 34, pg 962-969.

Hans Skariah, B.Sc., DMD
Promenade Court Dental Health Group in Mississauga
2233 Hurontario St., Mississauga, ON, Canada
(1/2 km north of the QEW in the Dome Building)
(905) 273-7100