Wednesday, September 6, 2017

Avoiding a root canal

Frequently patients will find my website, and come to my office, because they have been told they need a root canal or a crown, or both, and they just want to know if there are any alternatives. 
I've always been inclined to take challenges, especially when someone tells me something can't be done. 

Below is a picture of the tooth of a 77-year-old patient who was told this very thing.  She came to me because she would like to save this tooth, and she was told the only way to do so would require a root canal and a crown.  The other option she was given was extraction. 

Sure, this tooth looks pretty bad. There is decay well below the gumline, making this a truly "long tooth."  It would appear that there may also be decay approaching the nerve, which is presumably why a root canal was recommended.  This patient had no pain, and te x-ray did not show any sign of an infection.  In fact, the x-ray showed calcification of many of the nerve canals, which would make root canal therapy in this case potentially complicated and difficult. 

Now, if you wanna restore a tooth like this, you need the right tools and the right materials.  And you need to be able to clean out the debris so no decay is left behind!

Here the tooth is initially cleaned out using traditional instrumentation.  There is still a little bit of soft tooth structure left here, so I did a little bit more work, and then it was time to isolate.  Again, having the right tools available is key!

You can see this specialized matrix band is contoured and shaped to allow it to be submerged below the gumline, and to perfectly isolate the edge of the prepared tooth, which is clean and smooth and beautiful now.  Time to restore!

A bioactive material was used to restore this tooth to its natural form and function, and if I do say so myself, also restored the natural beauty of a lower bicuspid.  The bite was adjusted until it felt just right, and the patient left very happy that she was able to save this tooth, with a minimal amount of discomfort, for a fraction of the cost of a root canal and a crown. 

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