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The root canal filling material (3, 4, and 10) does not extend to the end of the tooth roots (5, 6 and 11). The dark circles at the bottom of the tooth roots (7 and 8) indicated infection in the surrounding bone. Recommended treatment is either to redo the root canal therapy or extract the tooth and place dental implants.
The proximity of the root to the canal can be assessed radiographically and there are several factors which can indicate high risk of nerve damage: [21] Darkening of the tooth root where it crosses the canal [21] Deviation of the canal [21] Narrowing of the roots [21] Loss of the lamina dura of the canal [21]
A tooth is unsuitable for periradicular surgery if it does not have a good periodontal support or coronal seal. It must have enough structure to support restoration. Filling the root canals of the tooth from the crown (orthograde root canal therapy) should be the first treatment option to resolve inflammation caused by the tooth.
A root canal is the naturally occurring anatomic space within the root of a tooth.It consists of the pulp chamber (within the coronal part of the tooth), the main canal(s), and more intricate anatomical branches that may connect the root canals to each other or to the surface of the root.
Tooth #5, the upper right second premolar, after extraction. The two single-headed arrows point to the CEJ, which is the line separating the crown (in this case, heavily decayed) and the roots. The double headed arrow (bottom right) shows the extent of the abscess that surrounds the apex of the palatal root.
Root canal treatment should be performed on the tooth if it is determined that previous therapy was unsuccessful. Removal of the necrotic pulp and the inflamed tissue as well as proper sealing of the canals and an appropriately fitting crown will allow the tooth to heal under uninfected conditions.
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