What's New in Root Canal Procedures?
In recent years, root canal diagnosis and treatment have become more efficient and less painful.
Local anesthetics have been improved. Nickel-titanium rotary instruments have replaced stainless steel files used to clean and shape the inside of the tooth.1,2 State-of-the-art surgical microscopes and digital X-rays provide much better views of the tiny areas that need attention.1
When there's something seriously wrong with one of your teeth that involves the dental pulp, your dentist or endodontist (root canal specialist) generally chooses one of two treatments: a root canal procedure or removal and replacement of the tooth. A tooth may be replaced with the following:
A recent review found that in some cases, root canal and dental implant treatments had almost equal success when it comes to the survival of the treated tooth or implant.3 The review, published in a 2007 supplement to the International Journal of Oral and Maxillofacial Implants, looked at 68 related studies. It found no major differences in the survival of compromised teeth that had been either restored with root canal therapy followed by a crown or replaced by a single tooth implant.3
That means the decision to treat a tooth with a root canal procedure or replace it with an implant should be based on such factors as the complexity of your case, your health, or your preferences.
The American Association of Endondontists has looked at various risk factors to help dentists and endodontists make this treatment choice. Risk factors for implant treatment can include smoking, bone quality, and estrogen level.4 For example, women with lower estrogen levels may not have as much success with implants.5
1 "Endodontists End Your Tooth Pain." American Association of Endodontists. www.aae.org/NR/rdonlyres/6B26DDED-93B6-4344-B662-7191C6F15DB4/0/EEYP_MATRelease.pdf. Accessed 2009.
2 "Efficiency of Rotary Nickel-Titanium K3 Instruments Compared with Stainless Steel Hand K-Flexofile." E. Schafer and H. Florek. Journal of Endodontics Research. March 1, 2009.
3 "For Teeth Requiring Endodontic Treatment, What Are The Differences in Outcomes of Restored Endodontically Treated Teeth Compared to Implant-Supported Restorations?" M.K. Iqbal and S. Kim. International Journal of Oral & Maxillofacial Implants. 2007, vol. 22, supplement, pp. 96-116.
4 "AAE Position Statement: Implants." American Association of Endodontists. www.aae.org/NR/rdonlyres/9312DC55-9571-4C12-96FF-97BD6811F6CB/0/implantsstatement.pdf. Accessed 2009.
5 "Dental Implants & Root Canal." American Association of Endodontists. www.aae.org/patients/pressroom/ImplantRelease.htm. Accessed 2009.