Regenerative endodontics is a relatively new form of treatment that is available to patients with damaged or disease pulp. Root canals used to be the primary approach to treating teeth that were in poor condition from infection or decay, but regenerative endodontics provides new options. While the days of traditional root canals aren’t quite behind us, a new age is dawning which may mean that this tried and true technique slowly fades into the past. In this article, we’ll introduce regenerative endodontics and what it means for the future of endodontic treatment.
Regenerative Endodontics vs. Traditional Root Canal Treatments
As the name implies, regenerative endodontics takes a new approach to treating pulp that has become infected or impacted by some form of trauma. Until the introduction of this treatment methodology, teeth that had pulp that was damaged or infected were treated using a root canal treatment. To understand just how different these two approaches are, it’s important that we touch on how root canal treatments are performed.
- Root Canal Treatments are used to remove damaged and infected pulp in the interest of saving the natural tooth. The stages of a root canal treatment are outlined below:
- Diagnosis – The diagnosis of a tooth for consideration for root canal treatment starts with digital imaging and a typical dental exam. Using these methods, your dentist will determine the extent of the damage and decide if a root canal treatment is appropriate.
- Preparation – Once you’re in the office for your procedure, your dentist will isolate the target tooth using a dental dam that will keep the treatment site clean and dry.
- Opening The Tooth – Using a drill, you’re dentist will open up the tooth so they can easily access all the points of decay or damage that are due to be removed. This step often requires the removal of additional dental tissue to treat the concern.
- Removal of Decay and Sanitation – The next stage involves the careful removal of all of the infected or damaged pulp followed by sanitizing the site. After this is done, the endodontist will place a material known as gutta-percha in place to seal the site.
- Temporary Cap – Finally, your dentist will seal the site with a temporary crown until your final one is prepared. In cases where these are made in-house, the temporary may be skipped in favor of putting the permanent crown in place.
This procedure focuses on the removal of the decayed pulp and sealing the site to ensure the infection doesn’t return. The drawback of this dental procedure is that the entirety of the pulp is typically removed, so there is no living tissue left inside the tooth. While adult teeth can survive without it, immature permanent teeth still require the support of this tissue. Root Canal Treatments tend to remove healthy pulp along with damaged and infected tissue to help prevent reinfection. Regenerative endodontics was developed to help restore tissue while stopping infection and decay.
- Regenerative Endodontics – Broadly speaking, regenerative endodontics is a procedure designed to help restore natural tissue and eliminate infection rather than the removal of the existing tissue. First developed to help immature permanent teeth that had become necrotic, it has since been improved and can help adult necrotic teeth as well. This procedure includes the following steps:
- Diagnosis – Like in the above instance, it’s necessary to diagnose the state of the tooth using dental imaging and a regular exam. Based on the results, it will be determined if regenerative treatments are appropriate.
- Preparation – Similar methods to a root canal treatment are used to prepare the patient and isolate the area where the procedure is to be performed. It’s at this point that the approach changes slightly.
- Accessing the Canal – Given that the goal is to restore full dental function and health, this stage of the process requires a little more finesse. The canal region must be opened so it can be accessed, but this has to be accomplished without damaging any healthy tissue.
- Cleaning and Sterilization – During this stage of the process, the core of the tooth is sterilized using a special solution that can address the infection but not damage any remaining healthy stem cells. Stem cells are at the core of the regenerative endodontic technique.
- Packing and Sealing The Tooth – This is the end of the first stage of the treatment. Following sterilization, the canal is filled with a temporary material to ensure the infection is gone. The next appointment will occur from one week to four weeks later.
- Second Treatment – In the event that the treatment is successful, the endodontist can then move forward. In some cases, a repeat of the initial treatment is necessary to eliminate any remaining infection. If no infection is found, they can move forward.
- Canal Preparation – Some last-minute preparations are made to prepare the tooth for the final stages of the treatment. This involves the removal of some remaining material and the preparation of the dentin for the next stage.
- Bleeding and Sealing – Bleeding is deliberately induced inside the tooth to fill the interior with natural material from the patient but is stopped before the tooth is full. The blood clot is then covered with a special material, and both are sealed using a final cap.
At this stage, the regenerative procedure is complete, though the healing process could take months or years to complete. As soon as the procedure is finished, another set of x-ray imaging will be done to determine the initial success of the treatment. Unlike the Root Canal Treatment, this process promotes the restoration of healthy dental tissue inside the treated tooth.
Ask Your Endodontist If Regenerative Endodontics is Right For You
Regenerative endodontics is an exciting new treatment for permanent teeth that have experienced decay and have become infected. The treatment allows the restoration of natural, healthy tissue rather than the tooth being filling with inert gutta-percha. If you want to know if your teeth can benefit from this treatment, reach out to your specialist and schedule a consultation today!