Private Dentists in Central London
020 7580 2551/1828
Advanced
endodontics
Separated instruments
Despite the use of brand new instruments and your dentist exercising great care and attention, small files sometimes break in fine canals (Figure 5). The broken file is no danger in itself but it prevents the canal system beyond it being cleaned. Our Endodontists are adept in the use of specialised instruments to remove these obstructions and clean the remainder of the canal system (Figure 6).
Our Specialists are experienced at treating technically demanding clinical challenges
Figure 5. A broken instrument.
Figure 6. The instrument has been removed
and the canals have been cleaned and filled.
Apicectomy
In a small number of cases infection persists despite thorough cleaning of the root canal system (Figure 7). This is caused by infection in the very complex fine anatomy that can exist at the tip of the root. In this instance the tooth can still be saved by a procedure called an apicectomy. This involves removing the infected tip of the root, cleaning the exposed root canal and placing a special filling in the end of the root (Figure 8).
Figure 7. This tooth still has a persistent infection despite a good quality root canal treatment. A dark area can be seen in the bone at the end of the root.
Figure 8. Root 18 months on, following apicectomy, showing healing of the bone.
Under normal circumstances apicectomies are only be carried out when a high quality root canal treatment has been unsuccessful in dealing with the infection. The exceptions are cases with well fitting crowns with excellent appearance and a post in the root but with a flawed root canal treatment that has resulted in an abscess. We can take the apicectomy one stage further and treat the whole canal up to the post from the tip of the root. This is a technically demanding treatment but is something that our highly trained Endodontists do routinely. It is called a ‘retrograde root canal treatment’ and an example is shown in Figures 9 & 10.
Figure 9. A central incisor tooth with a well fitting post crown but an underprepared and insufficiently cleaned canal system which is infected and causing symptoms. Notice the dark area in the bone above the root tip.
Figure 10. The same tooth 18 months later following removal of the tip of the root (apicectomy) and retrograde root canal treatment showing bone healing.
Plowman & Partners
Centre of Dental Clinical Excellence
London
Our two endodontists have invested heavily in post-graduate training and are recognised as Specialists by the General Dental Council. Both have extensive experience in dealing with these advanced techniques.
Full details of how to contact us are on our Contact Us page; or phone us on 020 7580 251/1828
Page author: Graham Bailey