Surgical vs. Non-Surgical Root Canal Therapy Q&A

An endodontist may use a surgical or non-surgical approach to root canal therapy to treat decay and infection and save the tooth. While the two techniques are similar, there are a few differences that are important to understand. The most common approach to root canal therapy is the non-surgical route. It is similar to getting a deep filling, as it is performed under local anesthesia and involves drilling into the diseased tooth.

After the diseased pulp is extracted, the endodontist reconstructs the natural form of the tooth. If the structure of the tooth is badly damaged, the specialist may place a metal post in the canal along with a temporary crown. One of the main advantages of non-surgical root canal treatment is that it can be performed in one visit.

A surgical root canal treatment, on the other hand, is usually performed if the non-surgical approach fails or if a more invasive technique is necessary to successfully address the infection. This technique is necessary to identify tiny fractures or hidden canals that were not visible on the pre-treatment X-ray. In this procedure, a small incision in the gum is necessary to access the root of the tooth.

Surgical root canal treatment, also known as endodontic surgery, root canal retreatment, or apicoectomy, is performed to remove damaged tooth pulp, address infection, and save the natural tooth structure. Your endodontist will carefully assess your circumstances to determine whether surgical root canal therapy is the right approach in your case.

During the treatment, the endodontist will make a small incision in the gum tissue adjacent to the diseased tooth. Now that the root tip is exposed, diseased tissue can be removed. Once the canals are cleaned, biocompatible material is used to reseal the tooth, just like in the non-surgical method. Lastly, the gum tissue is sutured to complete the process.

There are various techniques employed by endodontists to perform root canal therapy, such as:

• Traditional approach – Most commonly, endodontists opt for the non-surgical approach when performing root canal treatment.
• GentleWave treatment – The GentleWave system can effectively clean out hard-to-reach spaces within the root canal system by utilizing sound waves and fluids.
• Apicoectomy – Also known as root-end surgery, this treatment is necessary when inflammation or infection is not successfully addressed through the traditional approach.
• Pulpectomy – This procedure is typically performed on children with primary teeth that are severely infected. During the process, the endodontist removed all of the pulp from the tooth.
• Pulpotomy – As a minimally invasive procedure, a pulpotomy involves removing only the diseased portion of the pulp from the crown while leaving the healthy pulp in the roots intact.

The molars on the upper jaw, known as the maxillary molars, are considered the most difficult teeth to perform a root canal procedure on due to their location in the mouth and complicated root systems. These teeth often have three or more roots, each with its canal, and the canals themselves can be curved or branched in unpredictable ways. This intricate anatomy increases the difficulty of the procedure.

Even with advanced imaging techniques like digital radiography and cone beam CT scans, it can be challenging to get a clear view of the entire root canal system in second or third molars. Due to this, back molars may require a surgical approach to root canal therapy.

Furthermore, treating the molar teeth comes with a higher risk of complications such as missed canals, ledges, or perforations. For this reason, it’s strongly urged that you see an endodontist as opposed to a general dentist, as they have more expertise in performing molar root canals. The dedicated team at Ideal Endodontics can perform root canal surgeries, apicoectomies, and various other techniques to successfully treat damaged or diseased teeth. We are conveniently located at 11980 San Vicente Blvd Ste 900 Los Angeles, CA 90049. For more information, please contact us or schedule an appointment online. We serve patients from Brentwood CA, Santa Monica CA, West Los Angeles CA, Beverly Hills CA, West Hollywood CA, Venice CA, Culver City CA, and surrounding areas.