Canis ISSN: 2398-2942

Endodontics: root canal therapy

Contributor(s): Rachel Perry

Introduction

  • Endodontics Endodontics: basic is the branch of dentistry dealing with the diagnosis and treatment of diseases of the pulp.
  • Root Canal Therapy (RCT) is an endodontic procedure whereby the affected pulp is removed altogether (pulpectomy), the canal cleaned and shaped and then filled with suitable materials.
  • Theendodontic triadmust be adhered to for a successful outcome and involvespreparation,sterilizationandobturation.
  • RCT includes conventional RCT (orthograde) and surgical RCT (retrograde).
  • This component describes only conventional RCT.
  • Once a tooth is mature it can function without any pulp at all as long as it is periodontally healthy.

Uses

  • Fractured crown with pulp exposure Dental fracture Teeth tooth fracture Tooth: complicated crown fracture.
  • Deep carious lesions leading to pulp exposure.
  • Pulp exposure due to excess wear (attrition or abrasion).
  • Pulp injury resulting in hemorrhage or necrosis in a closed canal (usually a discolored tooth) Dental trauma: tooth discoloration Teeth pulpal necrosis 01.
  • Opaque teeth when transilluminated.
  • Pulp abscess or periapical abscess Teeth: periapical abscess.
  • Reimplantation of avulsed or luxated tooth Dental trauma: tooth luxation/avulsion.

Advantages

  • Alleviates pain and infection.
  • Considered preventative for future abscessation where a dead tooth is treated.
  • Allows retention of tooth form and function.
  • Less invasive and traumatic than surgical extraction.
  • Maintenance of mandibular strength (if mandibular canine treated).
  • Highly successful if performed well.

Disadvantages

  • Contra-indicated in fractured deciduous teeth Dental fracture.
  • Contra-indicated in teeth with an incomplete apex.
  • Contra-indicated in teeth with vertical root fractures Dental trauma: root fracture.
  • Contra-indicated in teeth with significant, uncontrolled periodontitis Periodontitis.
  • Impossible in old animals with inaccessible or sclerosed root canals.
  • Involves significant expenditure in obtaining correct materials and instruments.
    Verytechnique sensitive. Adequate trainingmustbe obtained before attempting this procedure in a live patient.
  • More expensive than extraction.

Requirements

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Preparation

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Procedure

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Aftercare

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Outcomes

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Prognosis

  • Root canal therapy in dogs may carry up to a 95% success rate.

Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Girard N, Southerden P, Hennet P (2006) Root canal treatment in dogs and cats. J Vet Dent 23 (3), 148-160 PubMed.
  • Kuntsi-Vaatovaara H, Verstraete F J, Kass P H (2002) Results of root canal treatment in dogs: 127 cases (1995-2000). JAVMA 220 (6), 775-780 PubMed.

Other sources of information

  • Perry R (2012)The Endodontic Armamentarium.In: Niemiec B A (ed)Veterinary Endodontics. San Diego: Practical Veterinary Publishing, pp 25-61.
  • Cohen S, Hargreaves K M (eds)Pathways of the Pulp.Missouri: Mosby Elsevier.
  • Niemiec B A (2005)Fundamentals of Endodontics.In: Holmstrom S E (ed).Vet Clin North Am Small PractPhiladephia: Saunders, pp 837-868.
  • Holmstrom S E, Frost Fitch P, Eisner E R (2004)Veterinary Dental techniques for the Small Animal Practitioner.Philadephia: Saunders.
  • Wiggs R B, Lobprise H B (1997)Veterinary Dentistry Principles and Practice.Philadelphia: Lippincott-Raven.


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