Endodontic dentistry addresses those situations where proper apical seal isn’t obtained. This happens when procedural error occurs; irretrievable materials exist in the root canal and in complex root canal anatomy cases.
Endodontic dentistry is used when all non-surgical methods to treat the tooth fail. Endodontic dentistry carried various procedural errors and risks in the past, due to the difficulty of accessing and visualizing the teeth apices.
Advanced technology has made the process precise, easier and with predictable outcomes. Enhanced illumination and magnification have strengthened endodontist’s ability to identify anatomical structures and defects for failure. These include craze lines, lateral canals, isthmus and fractures.
Modified surgical instruments accommodate a small size of bony window to expose the tooth apex. They allow higher incision precision and promote faster and better healing.
Endodontic dentistry provides a smoother and more precise cavity preparation as it follows the root’s long axis. It also allows for less bone removal to expose the apex as it is smaller than earlier microsurgical piece.
Super EBA and MTA are the top materials of choice for fillers as they seal better than amalgam and avoid tissue staining. Besides apical surgery, hemi sectioning, root retention, apical surgery and bicuspidization all fall within endodontic surgery’s range.
Points of Consideration
Endodontic dentistry, like any other surgery has certain limitations. Many anatomical factors, such as proximity to a maxillary sinus or neurovascular bundle, could pose potential limitations.
Presence of thick bone is another major issue. Apart from the thick bone plates, it contains lingually inclined roots, which means dentists have to remove a lot of bone to reach the apices.
Dentists need to evaluate the periodontal health of the tooth and the restorability, weighing the benefits against risk of treatment modality. In terms of outcome, technical advancement has made endodontic procedure more predictable and successful.