Re: Is there such a thing as a partial root canal?
- From: Mark & Steven Bornfeld <bornfeldmung@xxxxxxxxxxxxxxx>
- Date: Sat, 03 Feb 2007 17:26:33 GMT
John wrote:
On Feb 2, 3:21 pm, Newbie <n...@xxxxxxx> wrote:
On 2 Feb 2007 07:50:41 -0800, "John" <allen...@xxxxxxxxxxxxxxxxxx> wrote:
Everything I've read about root canals says that the entire root is
removed and replaced with gutta percha. But I would naively think that
if only the upper portion of the root is infected, or there is no
infection at all but only pain, that just the upper portion of the
root could be removed instead, thereby leaving a stronger healthier
tooth. Is such a "partial root canal" ever done, and if not why not?
Thanks.
The root is not removed, the contents of the root canal are removed
and sealed with GP plus a sealant in most cases.
I use the terms "root", "pulp" and "nerve" interchangeably. So, I
think of the "root canal" as the entire root content of the tooth.
And I understood "root canal therapy" to mean the removal of the
entire root, aka a "pulpectomy".
Partial RCT's are not done in adults because once the pulp
becomes infected ultimately it will die.
Why can't only the infected pulp be removed, leaving health pulp? Is
it because it is difficult to tell infected from non-infected? What
if there is only pain, but no sign of infection? Say the pulp nearest
to a filling has become sensitive through repeated trauma. Why can't
only it be removed leaving healthy pulp beneath it?
Pulpotomy is done on primary teeth but that is another animal entirely.
So, "pulpotomy" seems to be partial removal of the root (pulp). My
question was why is this never considered an option for adult teeth?
(though from Steven Bornfeld's response, it seems to be a current area
of research).
Traditional pulpotomies (generally done with some fixative agent such as formocresol--awful stuff BTW) used to be done more as short-term fixes for emergency patients until a complete root canal can be done. I have seen them done and never completed, and some of these SEEM to work. Very commonly the tissue in the canals under the pulpotomy filling tend to sclerose, and if there are symptoms afterward it is difficult or impossible to pass these canals--they become blocked.
Your use of the terms "pulp" and "nerve" interchangeably is understandable and not likely to cause misunderstanding. The same is not true for "root" and "root canal" (many roots contain multiple canals) and "pulpectomy" and "root canal treatment" (pulpectomy is the removal of the gross contents of the root canal; it specifically implies that the canals have not been entirely shaped and formed, and certainly implies that the canals have not been obturated.
I agree with Newbie that it is unlikely that direct pulp capping and/or pulpotomy is likely to enter the field as a definitive (as opposed to interim) procedure any time soon. However, some work IS being done in this area--and I've been wrong before about what's going to be around in 10-20 years.
Steve
BTW, I found a great site for information about teeth and dentistry.
It's http://www.doctorspiller.com/. To my layman's mind, it's
remarkably comprehensive and accurate. He mentions primary (baby)
tooth pulpotomy and an adult tooth pulp cap, but not adult tooth
pulpotomy, here: http://www.doctorspiller.com/Children's
%20Dentistry.htm#pulpotomy
--
Mark & Steven Bornfeld DDS
http://www.dentaltwins.com
Brooklyn, NY
718-258-5001
.
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