Los Angeles Family and Cosmetic Dentist

Culver City Dentist, Los Angeles Dental Implant Dentistry

At the center of a tooth is a hollow area that houses soft tissues, such as the nerve, blood vessels, and connective tissue. This hollow area contains a relatively wide space in the coronal portion of the tooth called the pulp chamber. These canals run through the center of the roots like pencil lead through the length of a pencil. The pulp receives nutrition through the blood vessels and sensory nerves carry signals back to the brain.

For many people who experience tooth pain or discomfort, a root canal may be recommended, and a dentist should be consulted in a timely manner. Root canal therapy has been shown to have great success rate as dental implants. The success rate shows that either one can have a ten year success rate of 95%.  Sometimes, when a previous root canal therapy becomes reinfected and a dentist may suggest a retreat of the root canal or an extraction and a dental implant.

However, most of the time when the initial treatment of the tooth fails a tooth becomes doomed  to extraction. This is because after having a root canal a second time around, most times the tooth becomes so structurally weak it cracks under the bite pressure.  Retreat of old failing root canals have been documented to fail over 70% of the time, which means only 30% survive after ten years.   Much less survive after ten years. 

To determine whether a Implant is the treatment of choice versus a saving the tooth with a root canal therapy, one has to consider 6 factors:

1. The patient and the the location of the tooth in the mouth and the mechanical force placed on it.  A strong male patient with strong facial muscles would probably have a very low prognosis.  While a more gentle female with a low facial muscle tone may have a better prognosis for saving a tooth.  The dentist must evaluate the opposing dentition to determine the load placed on the tooth.  Lower second molars tend to crack more often.  A patient that has harmful bruxing habits is more likely to crack a tooth or destroy the restoration over the tooth.

2. The amount of coronal tooth structure remaining .  A weak tooth structure which will not support the restoration or crown.

3. The access opening for the root canal.  If there are excessive internal tooth structure been removed the tooth will more likely crack even if covered by crown. 

4. The caries rate of the patient. In a patient who's teeth are decaying at a rapid and frequent rate will likely continue to decay even if a root canal therapy and a crown is placed on the tooth.
 
5. The restoration over the tooth as a bridge abutment and the number of missing teeth in the arch.  A bridge replaces multiple teeth and the forces of occlusion will  be transmitted over the the saved abutment tooth.  With high mechanical forces placed on the restoration the margins around the tooth will decay more quickly.  Also it is hard to keep good oral hygiene around bridge abutment teeth causing them to be doomed eventually to extraction.

Written by 
Meir Agaki, D.D.S.

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