Regenerative Endodontic Therapy 101

Categories: Miscellaneous

Root CanalRoot canal therapy saves millions of teeth each year. But sometimes, it isn’t enough. This is where regenerative endodontic therapy comes in. With regenerative endodontic therapy, endodontists can replace damaged structures in the teeth and restore functionality to infected or even necrotic root canal systems, thereby helping their patients retain their true teeth.

How Does Regenerative Endodontic Therapy Work?

While there are many types of regenerative endodontic treatment procedures, it is vital to know the procedure that most endodontists use. According to the American Association of Endodontics (AAE)’s Clinical Considerations for a Regenerative Procedure, possible candidates for regenerative endodontic treatment are patients who have a necrotic pulp, an immature apex, and a pulp space that is not necessary for post and core. Additionally, these patients should have no allergic reaction to the medication that will be given to them during the procedure. those with teeth that have a necrotic pulp, pulp space not needed for post and core, and an immature apex can get regenerative endodontic treatment, as long as they are also compliant and not allergic to the medication that will be given to them during the procedure.

During the first appointment, the endodontist should discuss the risks and benefits of the procedure after the initial diagnosis of the condition. The first step of the procedure is to anesthetize the tooth and to isolate it using a dental dam. Then, an access opening is created. Profuse, gentle irrigation with 20 mL sodium hypochlorite (NaOCl) is done to reduce the possibility of irrigants being extruded into the periapical space. Afterwards, the canals are dried with paper points and then calcium hydroxide or a low concentration of triple antibiotic paste is delivered into the canal system via a syringe. Lastly, the tooth is sealed with a temporary filling and the patient is dismissed for one to four weeks.

At the second appointment, the patient’s response to the initial treatment is assessed. The endodontist checks for signs of infection. If none are found, the tooth is once more isolated with a dental dam and the appropriate local anesthetic is applied. After making a coronal access opening, the tooth is again irrigated with 20 mL of ethylenediaminetetraacetic acid, followed by normal saline. The antimicrobial medication is removed completely. Then, the canal is dried with a paper point. Once it is dry, bleeding is induced in the canal system by placing a file in the canal. The bleeding is stopped at a level that allows for the addition of 3-4mm of the restorative material. A resorbable matrix is then placed above the blood clot. After that, about 3 mm of mineral trioxide aggregate is placed, followed by capping material.

Is It Effective?

Regenerative endodontic therapy is very effective, though it does have its limitations. For one, it is a very sensitive procedure that requires considerable training. Another limitation is that it causes tooth discoloration. However, this is an issue that can be easily fixed by using a double antibiotic paste (i.e., metronidazole and ciprofloxacin) or calcium hydroxide.

Despite its limitations, the overall benefits are noteworthy. Regenerative endodontic therapy saves more teeth and impacts patients’ lives more positively than a regular root canal. In fact, this treatment has the potential to revolutionize endodontic treatment as a whole.

If you’re looking for an endodontist who can expertly perform regenerative endodontic therapy, you can turn to none other than Creekside Endodontics. We know how much pain an infected tooth can cause, which is why we offer our endodontic services.

For more information, don’t hesitate to get in touch with us. We would be more than happy to hear from you!