A root canal procedure is performed when the central canal of the tooth becomes infected and/or damaged, which then threatens the very life of the tooth. Dentists want to try and save natural teeth whenever possible and a root canal can be the last step in trying to preserve the tooth.
Standard root canals are a fairly common dental procedure. But there are a few specialized variations that your general dentistry office might order depending on your specific problem.
A standard root canal removes all of the pulp material from inside the tooth's root canal and root structures. The canal is then filled with a bio-cement so that infection can't reenter the tooth. And yet there are cases when the tooth becomes infected again. Did the root canal procedure fail?
Not exactly. The standard root canal cleans the pulp out of the root structures that are easy to access from inside the tooth. But the roots also have tips that stick down into the jawbone. And those tips, or apexes, can become infected and allow the infection to take hold in the bottom of the tooth.
An apicoectomy can solve this problem. In this procedure, the dentist will gain access to the apexes through the gums and bone. Ultrasonic equipment is used to remove the apexes and seal the area back up so that the infection has to stay out for good.
Pulpotomies involve removing affected pulp only from the uppermost portion of the crown. The procedure leaves the root nerves intact so that the tooth is still fully alive but now relieved of the damaged bit of pulp.
A pulpotomy is only good for situations where there is minimal damage to the pulp and is most common in pediatric dentistry. A pediatric dentist can use a pulpotomy to protect a damaged baby tooth to keep it from falling out before schedule. Early loss of a baby tooth can cause the permanent tooth underneath to emerge too early, which can create bite issues.
A pulpectomy is fairly similar to a regular root canal in that each procedure removes pulp both from the upper canal and down into the tooth root nerves. But there are two primary differences.
First, a pulpectomy stops at the top of the tooth roots where the pulp ends rather than going to the bottom as a regular root canal would. Secondly, pulpectomies are more often done in pediatric dentistry while regular root canals are for adults.
Why the differences? Leaving the very tips of the roots intact will keep the tooth alive for a while longer. This is particularly important in the case of affected baby teeth. And a traditional root canal ends with a permanent dental crown to seal everything closed, which isn't necessary for a baby tooth that doesn't need to last much longer.