All About Root Canal Therapy

ROOT CANAL THERAPY: ALTERNATIVES AND PREVENTION

When confronted with a deep cavity inside a tooth, many patients think root canal therapy is their only option, even if the tooth’s nerve is healthy and vital.

Fortunately, e.s.i. Healthy Dentistry can preserve healthy tooth nerves with the deepest cavities.

Utilizing the unique technology of the SPECTRA system, Ozone nerve therapy, and other innovative procedures, materials, and technology, Dr. Kilimitzoglou and Dr. Patrie have a very high success rate in avoiding root canal therapy for their patients.

THE FIRST CRITICAL STEP IS TO ASSESS THE VITALITY OF THE NERVE INSIDE THE TOOTH

If the nerve has not been contaminated by bacteria from a long-standing cavity and the nerve is nor irreversibly inflamed, vital Ozone nerve-therapy is an ideal treatment option in order to avoid root canal therapy. Its key to success is in creating a bacteria-free environment that allows the nerve to heal and recuperate.

ONCE THE NERVE VITALITY IS CONFIRMED, ALL THE DECAY IS REMOVED FROM THE TOOTH

Dr. Kilimitzoglou and Dr. Patrie utilize a new generation of ceramic drills to selectively remove the tooth’s decay, all the while leaving the healthy tooth structure intact. Preserving healthy tooth structure is a core tenet of our minimally-invasive dentistry philosophy.

The last remaining portion of tooth decay is treated with Ozone gas nerve therapy. Ozone gas fumigation specifically kills bacteria, fungi, viruses, and prions without any harm to human cells. Then, an innovative device called SPECTRA is used to scan the tooth and determine if all of the bacteria in the softened dentin is obliterated. The SPECTRA gives both visual and numerical confirmations in real time. Patients love seeing the progression and final disinfection of their tooth on the SPECTRA’s television screen!

Following the Ozone nerve therapy, the sterilized soft dentin is covered by a revolutionary new dental material that has been in development in Japan for over ten years and is now available in the United States. This material adheres to the building blocks of the tooth’s structure, softening dentin and allowing the tooth to remineralize.

THE TOOTH IS THEN SEALED, AND IT IS RESTORED WITH A BIOMIMETIC RESIN-COMPOSITE TOOTH-COLORED FILLING

By using materials that mimic the natural structure and colorization of the tooth, our restorations restore harmony to the mouth. Unfortunately, Ozone nerve therapy does not work on infected or abscessed teeth where the nerve in necrotic, nor on teeth where the nerve in chronically or irreversibly inflamed. In these cases, the patient waited too long to seek treatment. But hope is not lost. Today, it is possible to remove the tissue and bacteria from the tooth using the highly effective combination of the laser PIPS protocol in conjunction with Ozone nerve therapy. This modern technique allows Dr. Kilimitzoglou and Dr. Patrie to seal the tooth with a bonded adhesive core that keeps bacteria from invading the tooth yet again!

UNDERSTANDING ROOT CANAL TREATMENT

The tooth is made up of 2 hard tissues the Dentin and the Enamel. The enamel is a rock hard outer shell of the tooth. It is a transparent-whitish tissue that is 95% crystal and 5% collagen. Enamel is the hardest tissue in our bodies and is designed to withstand the abrasive nature of chewing. Dentin makes up the inner core of the tooth as well as the roots. Dentin is 50% crystal / 50% collagen and is a firm, flexible tissue similar to bone, but much denser. It is made up of millions of microscopic tunnels where tiny extensions of the nerve reside. That is why exposed dentin is “sensitive”. Inside the dentin core and the roots is the Pulp. It is composed of blood vessels, which nourish the tooth, and the nerve that gives sensation to the tooth. Blood vessels and the nerve enter an exit the tooth trough a pin-sized hole at the tip of the root. The nerves in our teeth have only one “feeling” PAIN!

WHY DO TEETH “DIE”?

The pulp lives inside the tooth, which can be thought of as a “hollow rock”. Its only entry and exist is a pin-sized hole at the tip of the root. Anything that cause pulp inflammation caused the nerve to hurt. Inflammation causes swelling and as the tissue inside the tooth expands it has no-where to go. Given enough time or enough swelling the nerves and blood vessels inside the tooth become crushed or asphyxiated, eventually leading to nerve death. The nerve can deal with a little inflammation as when eating something very cold or hot, or a minor tap on the tooth. However, trauma, deep decay, improperly placed fillings or crowns and cracks in teeth can all lead to irreversible pulp inflammation and eventual nerve death. This is a very painful process!

HOW DO TEETH DIE?

When the pulp is inflamed and the inflammation is constant the nerve begins to die. This is often a very painful process. The pain is described as bad as the worst earache and worse than childbirth! Eventually after several days or weeks the nerve dies and the pain goes away. If you have been taking pain medicine to mask the pain and wait it out until the pain goes away, you may think everything is OK! Unfortunately, the tissue inside the tooth is silently decomposing. This is called tissue necrosis or putrification. The tissue first liquefies, and then gas is released. This gas eventually begins to put pressure on the one exit: the pin–sized hole at the tip of the root. At this point pain to HOT foods or drinks is felt because the heat expands the gas, putting more pressure on the bone surrounding the tooth. The gas pressure causes the bone surrounding the root to liquefy or necrose, causing an abscess. If there is bacteria present in the tooth form a cavity, a tooth crack or poorly fitted filling or crown an infection follows. This infection can spread to the face and in rare instances to the brain. People have actually died from untreated tooth infection!

WHAT IS ROOT CANAL THERAPY?

The mention of "root canal" sends shivers down peoples spines. Here at E.S.I. Healthy Dentisty, our treatment results have become much more successful with our holistic root canal therapy approach using a combination of laser and ozone disinfection protocols. We utulize the Powerlase AT Dental Laser combined with ozone to thoroughly disinfect the root canal system. We have the Er: Yag laser with specialized fiberoptic tips in the P.I.P.S. protocol. The P.I.P.S. protocol kills bacteria inside the small side branches of tooth root canals and within dentin tubules. Ozone gas disinfection can accomplish similar results. By combining both disinfection protocols together, we achieve thorough root canal and tooth disinfection. This goes beyond traditional rinse disinfection. Instead of using multiple x-rays to determine the length of the tooth root during treatment, our office utilizes a mini-computer to do the same job. This means much fewer x-rays during your root canal treatment.

Root Canal Therapy is the careful removal of the sick pulp from the center of the tooth and the roots, followed by disinfection and sealing of the empty space that once housed the pulp.

LASER ROOT CANAL TREATMENT

The sad truth is that it is not uncommon for teeth that have had root canal therapy to remain infected. The persistant root canal infection is usually diagnosed months or even years after the root canal treatment was done. It is very frustrating to find out that your root canal therapy failed after having spent a large sum of money, time and possibly pain.

One of the major reasons for root canal treatment failure is that bacteria and nerve tissue not being thoroughly removed form the root canal system. Traditionally, most dentists use chemical rinses like bleach (chlorox), peroxide, chlorohexidine and iodine to disinfect and digest the tissue and bacteria inside the root. The trouble is the nerve inside the root is designed like a tree: a main trunk and many intricate branches that spread sideways. Most of the branching occurs in the last 1/3 of the root tip, but sometimes branches come from the main trunk in the mid 1/3. In the past we could only clean the main trunk with thin instruments and rely on the rinses to "take care" of the branches.

Today we finally have a dental root canal laser that can thoroughly clean all the side branches effectively and predictably: PIPS protocol with Er:Yag Powelase AT dental laser and specially designed PIPS fiberoptic tips. P.I.P.S. (Photon Induced Photoacoustic Streaming) is the only proven Laser root canal therapy today. Specifically, the Powerlase AT laser is the only dental laser that has been shown by several studies to remove extensive tissue and bacteria inside the tooth.

Video Below demonstrating the photo-acustic stimulation of liquid in side a transparent tooth using PIPS root canal laser. The PIPS system is the new, revolutionary method for thoroughly cleaning the root canal system using laser energy. Harnessing this power, the PIPS laser trough a specially designed fiberoptic tip creates shock waves. The laser energy pulsates through a disinfecting liquid placed inside tooth's root canal. Because the shockwaves are contained within the tooth root, the solution is able to stream through the entire canal system, thoroughly removing debris and killing bacteria. As a result, the entire root canal system is left completely clean. This has been confirmed by powerful electron microscopes that can see even the smallest bacteria. The PIPS laser root canal treatment protocol even kills bacteria inside the small side branches of the root canals and within the microscopic tubules inside the tooth itself (dentin tubules). Going beyond traditional rinse disinfection addresses the issue of bacteria and pulp tissue being left behind in the tooth.

OZONE ROOT CANAL THERAPY

One of the major failures of conventional root canal therapy is the inefficient sterilization of the root canal system by chemical means. Side branches of nerves and microscopic dental tubules are virtually impossible to clean with conventional liquid chemicals. Often, micro-organisms are left in the tooth causing persistent infection and perpetual release of toxins from the tooth into your body.

It is not unusual for people to spend thousands of dollars and many hours in the dental chair only to have their tooth continue to have an infection requiring additional treatment, cost, time, pain and aggravation. Sometimes the tooth is lost despite all efforts to save it.

We have been having success with our laser root canal therapy protocol using the Powerlase AT’s Photon Induced Photoacoustic Streaming(P.I.P.S.). Combined with the latest diagnostic tools such as the Galileos CBCT 3-D low radiation x-ray scan to see all the canals and identify infections and cavitations which are difficult to discern with 2-D x-rays.

When it comes to root canal therapy removing all the bacteria from every part of the tooth is critical. It turns out Ozone is the perfect addition in our effort to achieve 100% germ-free root canals. Ozone or O3, a derivative of Oxygen, is highly effective safe gas that is used in selectively killing bacteria, viruses, fungi, parasites and prions, while not affecting human cells! Ozone gas is safe and allergy-free.

Ozonated water combined with the Laser P.I.P.S. protocol is used in the initial stages of root canal cleaning and debridement. Ozone gas fumigation is the last step of our root canal disinfection process prior to sealing the root canal system. Ozone gas not only penetrates the accessory root canal branches, but it also helps disinfect the millions of dentin tubules within the tooth. Ozone works by creating peroxides, which is the way our own immune cells kill germs. This extremely effective germicidal use of ozone is completely safe, has no side effects and, unlike chemicals, ozone leaves no toxic byproducts.

e.s.i. Healthy Dentistry uses the safest ozone generating device available. In addition, we only use medical grade pure oxygen to manufacture our ozone for our patient’s safety.