Root canal therapy (RCT) followed by a crown is the most common mode of treatment for severely decayed teeth. However, this is not devoid of failure. In another case, if a tooth could not be salvaged by RCT, then extraction followed by a bridge (replacing the removed tooth with support from adjacent healthy teeth) became the next best option.
In both cases, especially latter, healthy teeth are being manipulated to support the tooth being replaced. The next quest was to work without touching the sound tooth. So, instead of taking support from adjacent teeth, thought was given to provide support from within the bone - very similar to how a natural tooth stands. The lost root is replaced by a compatible metal, on which a tooth crown is then built. This was the beginning of dental implants, which has gained significant popularity over the last two to three decades.
-Does not affect adjacent healthy teeth
-Functionally better, as it has stronger support from the bone
-More esthetically appealing
-Maintain facial bone and soft tissue structure
-Better for the gum health compared to bridges
-Easier oral hygiene practices
Mechanism: A strong, biocompatible material is used to make screws which are inserted into the bone. Titanium is the most preferred material, and because of its unique property of osseo-integration (fuses with the bone), it fuses with the bone to reduce bone loss after the tooth is gone. In most cases, the titanium screws which act as the root for the implants are placed into the bone and allowed for some weeks to few months to fuse with the bone. Then, an interim crown may be used until the screw is ready to take on an implant. The screw is periodically monitored and once it is completely accepted, then an abutment is placed on it. This acts like a stump or a root, over which a crown will be placed.
Though most implants are done for replacing single teeth, in many cases, multiple teeth may be replaced using abutments. If the missing teeth are adjacent to each other or in the same quadrant, then a denture might be overlaid over the abutments. Alternately, a partial denture may be used which is screwed over an abutment.
Maintenance: Regular brushing and flossing, rinsing and mouthwashing assume a greater significance in patients with implants. Also, regular visits to the dentist are a must.
Dental implants are a boon for missing teeth, with the various advantages. However, it is not for all, with excellent bone health being one of the prerequisites. A thorough dental examination will help determine if you are the right candidate. Visit your dentist to find out more.
When a small cavity isn't treated on time, the tooth may get so badly decayed that normal filling cannot solve the problem. In such cases, your dentist will probably advise you to have a root canal. When performing a root canal, the dentist will remove the nerves and pulp within the tooth, clean the inside of the tooth and seal it. After this procedure your tooth will not sense anything and should be pain free. However in some cases, you may still experience pain after a root canal.
There are four main causes of this pain:
1. Swelling of ligament around the tooth
One of the signs that you need a root canal is swelling of the gums. Even after the nerves and pulp within the tooth are removed, the ligaments around the infected tooth may still be swollen. This can take some time before the tissue is normal again. In most cases this is the cause for pain after a root canal procedure.
2. Damaged tissue
Part of the root canal procedure is to clean the insides of the tooth. Here the dentist must be very careful to not go beyond the tooth. In some cases the file used to clean the tooth may go beyond the root and damage the tissue there. Another possibility is that the sealant used to fill the tooth may go beyond the root thus aggravating the tissue. This can take some time to heal and can cause pain.
3. Excess filling
After the tooth has been cleaned, the dentist fills the tooth with a sealant. If excessive sealant is filled in the tooth, it may become taller than the surrounding teeth. This makes you hit that tooth first when you close your jaw and puts extra pressure on it resulting in soreness and pain. Your dentists will need to remove the excess sealant to resolve this issue.
4. Phantom pain
Phantom pain is rare when it comes to root canals. This occurs when the nerve leading upto the tooth still behaves like it were connected to the tooth despite the nerve within the tooth being completely removed. The peripheral nerves will need to be treated to resolve this issue.
In most cases , these events cannot be prevented. There is also no reason to expect that this is a symptom of your root canal being a failure. Stay in touch with your dentist and brush and floss your teeth regularly. You will soon notice the pain subsiding.