Referral & Clinical

Fractured Teeth - Root Canal Treatment

The most common reason for case referral.

Fractured teeth with pulp exposure can be root filled or extracted – NEVER left to "wait and see what happens". Root canal treatment can save these teeth without the problems encountered with a difficult extraction. It often takes around the same time as an extraction - but endodontic treatment maintains the function and appearance of the tooth with a much better result for the patient. Standard endodontic treatment carries a very good success rate of over 98%.

The tooth below fractured when the dog caught a stone. Within hours the pulp is infected and inflamed creating a classic "toothache" or pulpitis. Our options at this time are to remove the tooth or to remove the pulp - a root canal treatment. The pulp below was so painful the dog would react when it was touched - even under full anaesthesia!

We use a variety of the latest techniques to provide the most appropriate treatment for the tooth. This may involve the latest technology in veterinary endodontics. The files used are LightSpeed™ nickel titanium reamers which are used in an ultra-slow handpiece for internal canal shaping and cleaning. These files clean the internal canals walls predictably and exactly where needed without the problems previous motor driven files experienced with binding and breaking in long root canals.
We also use a mixture of cements and gutta percha filling techniques depending on the circumstances. The LightSpeed Simplifill plugs used with the LightSpeed files and an epoxy resin cement provide a solid and predictable apical fill (very important) every time. Novel gutta percha techniques, such as GuttaFlow, used in conjunction with Simplifill plugs have been proven by independent peer reviewed papers to be the most durable fills in animals.

The image below is an electro- micrograph of bacteria in the pulp chamber and dentine tubules following exposure of pulp by fracture..

Fractured 108: RU premolar 4 Fractured 404: RL canine

LightSpeed file to working length Final fill with GuttaFlow and cement

These new technologies and techniques make challenging canals less of a problem. In our experience a mixture of the modern and traditional is often the most efficacious. Not all fractured teeth can be root filled. Any tooth with a long axis fracture below the bone crest is not suited to root canal work. Also any tooth with moderate to severe periodontal disease. We will carefully asses any tooth before treatment and advise before proceeding.

The PDF file below provides you with a Powerpoint presentation we use in the consulting room as an illustration. Click on the arrows on the top left of the page to run the images.

Alternatively use this link to download the PDF - Powerpoint Root Canal