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Endo-dontics to the "Rescue"!

11/10/2018

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TO LAST BLOG---10-17-2018--MUSCLES' Autumn Message!

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COMPLETE DENTISTRY STUDIO ---253 East Center St---Manchester, CT 860-649-4435

MUSCLES:
' So---last dental blog we ended with
the pulp-of-the-tooth "dying-off" from
either the TOP crown-of-the-tooth to
the BOTTOM root's apex---OR from
the BOTTOM root's apex UP into the
the root-canals & pulp-chamber. How
does "endo-dontic" treatment fit into
this story of the "dying-pulp"? I like
the "rescue" part----cuz' remember
you rescued me and I rescued YOU!!
But WHY is "endo-dontics" a "rescue"? '

Dr Skerpan: Last dental blog we covered the reasons WHY a tooth can "die-off".
Remember, "endo-dontic" treatment involves the "INSIDE-of-the-TOOTH" (more
on this treatment below). This internal treatment is needed if the inside pulp has
died-off" from TOP-to-BOTTOM OR BOTTOM-to-TOP. "Endo-dontic" treatment
should be performed in any scenario where the pulp is compromised. Keep in mind
that more often than not, there are no warnings or any pain associated with a tooth
needing "endo-dontic" treatment. Furthermore, very often x-rays do not show the
extent of pulp-death from decay, fractures or traumas!

The tooth's pulp can be traumatized from any
direction and from anything that disturbs or
affects theintact pulp components. Any violation
of the pulp-tissue will cause the tooth's inside
pulp to "die-off", causing internal tooth infection.
An abscess at theroot's apex will ensue, "feeding"
off the internal infection and eventually causing
infection & resorption of the bone (see picture at
the right). "Endodontic" treatment is required if
an infection from pulp-death has already occurred,
as the pulp is in the process of "dying-off" OR if
pulp-death is inevitable. In any these scenarios
the decay, fracture or trauma has already blatantly
and obviously encroached onto the pulp tissue.

An abscess IN the bone occurs FROM the INSIDE pulp infection at the root's apex.

There is one other scenario where the tooth may require "endo-dontic" treatment
--a situation where it may be necessary to intrude into the pulp deliberately. For
example, it may become impossible to properly contour &/or treat a poorly-posi-
tioned, poorly-shaped or over-extruded tooth. In such a case, the best option may
be to perform "endo-dontic" treatment to obtain a healthier proper-function &/or
a more aesthetic final result.

DECAY or FRACTURE intruding onto the PULP-tissue.......

.......or any TRAUMAs to the PULP-tissue will cause the pulp to "die-off" & become the "nidus" of an INFECTION.

MUSCLES: ' But WHY does "endo-dontic" treatment exactly "rescue" a tooth from
an infection and abscess? '

Dr Skerpan: Remember that the pulp can not be repaired after it has "died-off"--
& that the dead-pulp-tissue is the "nidus" for the internal tooth infection. If such a
pulp situation is not resolved, the infection will affect the bone at the root's apex,
causing an infection & resorption ("eating-away") of the bone---also called a dento-
alveolar abscess (or a "TOOTH-to-BONE infection").

"Endo-dontic" treatment "rescues"
the tooth by giving the tooth "one-
last-chance" to function in and with
the bone. With no pulp left within
the tooth after "endo-dontic" treat-
ment, the circulation and any con-
nection thru' the root's apex with
the bone no longer exists (see pic-
ture at the right). However as long
as there is no infection remaining in
the TOOTH OR BONE, the tooth still
can function in and with the bone!

"ENDO-DONTIC" treatment terminates this TOOTH-to-BONE CIRCULATION!

This is WHY "endo-dontic" treatment
works and "rescues" the tooth from
extraction!! If the "PERIO-DONTAL
STRUCTURES" are healthy & intact
(and no infection remains), they can
continue to function with the tooth's
external root surface without any
circulatory connection thru' the root's
apex-opening!! THE TOOTH REMAINS
VIABLE WITHIN THE BONE--AND
THE external TOOTH-to-BONE RELA-
TIONSHIP CONTINUES TO SURVIVE!!

With NO PULP and with NO INFECTION---healthy "PERIO-DONTAL STRUCTURES" will maintain the external TOOTH-to-BONE relationship!

MUSCLES: ' I "feel like digging" into HOW "endo-dontic" treatment is actually
performed on the tooth. Can we "dig" into the actual "rescue"
procedure itself? '

Dr Skerpan:
From the previous dental blog we know WHY a tooth "dies-off" in the first place.
And now we know WHY an "endo-dontically" treated tooth still can function in
the jaw-bone & body! Understanding that there is no pulp left within a tooth
after "endo-dontic" treatment, we now can "dig" into the Nitty-Gritties of HOW
the actual procedure is performed to "rescue" a tooth (see our next dental blog).