Before starting root canal treatment, a differential diagnosis of a “live tooth” or a “dead tooth” is made, along with a comparison of clinical examination results and X-ray images with the patient's history. A digital X-ray of the tooth provides additional insight. These findings are the basis for analyzing the visible and internal parts of the tooth.
Endodontics and Root Canal Treatment
If a deep cavity is detected on an X-ray or during a clinical examination, the pulp of the tooth is carefully opened for complete caries removal, and root canal treatment is carried out, which has a high chance of success.
Dead Tooth – Treatment
Dead teeth can cause gangrene or tissue necrosis, in simple terms, they can rot. This process of tissue decay and the resulting metabolic imbalance can lead to severe or intense tooth pain that is difficult to numb. Typically, X-rays reveal clear radiolucency at the apex and surrounding tissues. Root canal filling is NOT performed during the first session.
Dead teeth do not respond to cold or heat. They may be loose or firmly embedded in the gums. They may or may not show signs of abscess or fistula. These teeth can be sensitive or insensitive to tapping or biting. The decisive factor here is the X-ray or orthopantomogram. Anesthetized trepanation usually occurs without bleeding.
Such endodontic procedures are generally performed using a dental microscope. A dental or surgical microscope ensures optimal control during the canal filling process with enhanced visibility. Flexible titanium files and specialized ultrasonic files are also used alongside a mini handpiece for precise control.
The main goal when treating root canals is the complete and effective cleaning and filling of the branched alveolar canal system.
Endodontics does NOT imply saving every tooth that is severely decayed or has nonviable roots. Endodontic treatment is worthwhile if the result is a functional tooth with a strong, healthy or partially healthy crown, while preserving as much of its internal and external structure as possible! Even with successful endodontic therapy, a dead tooth, unlike live tissue or sterile synthetic material, can negatively affect the body’s metabolism.
Root Canal Treatment or Dental Implant
Patients who are highly committed often try to save dead teeth through endodontics. Preserving a tooth at all costs through endodontics can lead to complications during future surgeries or oral rehabilitation, when the remaining roots may be extremely difficult to extract. Over time, a dead tooth loses support and may fuse partially or fully with the jawbone. This fusion may require a complicated and unpleasant surgical removal, especially if it leads to bone tissue atrophy around the tooth and results in aesthetic issues.