Tag: root canal

Categories : Dentistry Regenerative MedicineTags :

Tissue Regeneration might One Day Replace Root Canals

On By ModernMedia
Photo by Caroline Lm on Unsplash

Tissue regeneration might one day replace the pain and discomfort of a root canal for most people. ADA Forsyth scientists are testing a novel technology to treat endodontic diseases (diseases of the soft tissue or pulp of the teeth) more effectively. The technology may also even be applicable to other parts of the body, such as helping to regrow bones.

The study, published in The Journal of Dental Research, demonstrates regenerative properties of resolvins, specifically Resolvin E1 (RvE1), when applied to dental pulp. Resolvins are part of a greater class of Specialised Proresolving Mediators (SPMs). This class of molecule is naturally produced by the body and is exquisitely effective in the control of excess inflammation associated with disease.

“Pulpitis (inflammation of dental pulp) is a very common oral health disease that can become a serious health condition if not treated properly,” said Dr Thomas Van Dyke, Vice President at the Center for Clinical and Translational Research at ADA Forsyth, and a senior scientist leading the study.

“Root canal therapy (RCT) is effective, but it does have some problems since you are removing significant portions of dentin, and the tooth dries out leading to a greater risk of fracture down the road. Our goal is to come up with a method for regenerating the pulp, instead of filling the root canal with inert material.”

Inflammation of this tissue is usually caused by damage to the tooth through injury, cavities or cracking, and the resulting infection can quickly kill the pulp and cause secondary problems if not treated.

The study applied RvE1 to different levels of infected and damaged pulp to explore its regenerative and anti-inflammatory capacities.

There were two major findings. First, they showed RvE1 is very effective at promoting pulp regeneration when used in direct pulp-capping of vital or living pulp (replicating conditions of reversible pulpitis). They were also able to identify the specific mechanism supporting tissue regeneration.

Second, the scientists found that placing RvE1 on exposed and severely infected and necrotic pulp did not facilitate regeneration.

However, this treatment did effectively slow down the rate of infection and treat the inflammation, preventing the periapical lesions (abscesses) that typically occur with this type of infection.

Previous publications have shown that if the infected root canal is cleaned before RvE1 treatment, regeneration of the pulp does occur.

While this study focused on this technology in treating endodontic disease, the potential therapeutic impact is far reaching.

Dr Van Dyke explained, “because application of RvE1 to dental pulp promotes formation of the type of stem cells that can differentiate into dentin (tooth), bone, cartilage or fat, this technology has huge potential for the field of regenerative medicine beyond the tissues in the teeth. It could be used to grow bones in other parts of the body, for instance.”

Source: Forsyth Institute

Categories : DentistryTags :

Root Canals Still Preferred Over Tooth Extraction

On By ModernMedia
Source: Unsplash

Few patients regret having a severely damaged tooth saved by a root canal filling, with a PhD thesis finding that 87% would choose the same treatment again if needed, despite the pain and discomfort.

Root fillings are often required because the soft tissue inside the tooth, the dental pulp, is inflamed or infected. The root canal treatment is carried out in stages, on several occasions, where the dentine and other parts are removed and the root canals are finally filled with a combination of a natural, rubberlike material (gutta-percha) and a cement.

Root canal treatment is still a common and necessary measure despite good oral health. In Sweden, as in most countries, most root canal treatments are performed by general dental practitioners in the public or private sector.

In dentist Emma Wigsten of the Institute of Odontology’s thesis, several studies analysed data on a patient group of 243. All of them had started root canal treatment at one of the 20 public dental clinics in the region, and the patients were then followed up for one to three years.

Most of the root canal treatments were prompted by toothache in teeth with caries and large restorations, which culminated in root fillings within a year. Molars were an exception: only just over half of the root fillings met their purpose and, as a result, many molars had to be extracted.

“It seems harder to get a good result in treating the molars, despite time and resources invested. Root canal treatment is complicated: You’re working inside the tooth where you can’t see anything, and the further back you go in the mouth, the more difficult it becomes,” Wigsten said.

“Root canal treatments of molars involve significantly bigger challenges than other tooth groups. So it may be important to investigate whether root canal treatments of molars should be performed to a greater extent by dentists specialising in root canal treatment.”

During the follow-up period of up to three years, half of the patients stated that they had mild pain or discomfort from their root-filled tooth. Nevertheless, most (87%) were satisfied and did not regret opting for root canal treatment over a tooth extraction.

Another component study, at six public dental clinics in Region Västra Götaland, covered 85 patients in whom either root canal treatment was initiated or a tooth was extracted. An improved health-related quality of life was observed in the patients who started root canal treatment, but not in those who underwent a tooth extraction.

“The studies show that the patients’ quality of life benefited from root canal treatment. On the other hand, it’s unclear whether the treatment is cost-effective compared with tooth removal, especially where molars are concerned,” Wigsten concluded.

Source: University of Gothenburg