When do I need a tooth replacement after root canal treatment? | Health


Oman- The field of restorative dentistry has come a long way, especially with the development of techniques and materials such as porcelain, zirconia and other modern materials, which have had a positive impact on the health and well-being of patients.

Many people replace missing teeth with dental restorations to restore oral and aesthetic function, which plays a vital role in improving the patient's quality of life.

Endodontist Dr. Muhammad Al-Qadiri said root canal treatment is a critical procedure to save teeth that are deeply decayed or have root damage. Severely damaged crowns may require dental restoration to ensure their continuity and protect them from fractures that could lead to their permanent loss.

In a statement made exclusively to Al Jazeera, Al-Qadri explained that if more than 50% of the crown part of a tooth is destroyed due to decay or fracture, it is recommended to make a veneer or crown (dental crown) for the tooth to protect it against fractures and ensure its durability, as the installation maintains the strength of the tooth and prevents its loss, as it is clinically and radiologically assessed by the treating physician.

Kadiri said that while root canal treatment can reduce the internal nutrition of the tooth, it does not reduce the strength of the tooth, and the tooth can continue to function normally for many years with the support of nutrition from the surrounding tissues and, in some cases, a crowning procedure to protect the tooth from fracture.

Al-Qadiri explains that not every tooth will need restoration after root canal treatment, and in some cases, a simple restorative filling may be sufficient, with regular follow-up visits to the tooth to ensure its health and strength, and if the damage is minor, less than 50%, it may be sufficient for a restorative filling.

Dental nutrition

Al-Qadiri added: “The treated tooth is deprived of nutrients from the inside, but it is still nourished by the surrounding tissue, which allows it to continue to work effectively for many years, just like a dental implant.”

“If the nerve is alive and dead, we will restore the tooth with a cosmetic filling, however, if the tooth needs to be improved in appearance with a porcelain veneer, nerve treatment may not be necessary, provided the condition is assessed and the tooth is properly prepared before the permanent veneer is placed,” Al-Qadiri explained.

However, for teeth with crowns attached, root canal treatment can be performed, provided the existing crown or crowns are removed to fully evaluate the tooth. If the crown is properly placed and there is no internal leakage, the root canal treatment process can be performed after the crown is removed and an opening is made in the crown to access the internal nerve canal, which can then be accurately sterilized and filled.

Kadri added that these procedures are designed to preserve the teeth and their continuity, which helps improve their function and appearance without the need for surgical procedures or expensive interventions.

Tooth root design, teeth, crowns, tooth anatomy, root crowns
The anatomy of the tooth (island)

Compensation Process

Dr. Rami Al-Daghim, a prosthodontist, said prosthodontics is the process of replacing collapsed or missing tooth structure for both therapeutic and cosmetic purposes, where dentists replace lost tooth structure with ceramic, metal or acrylic materials (a type of synthetic fiber) to restore the tooth to its original shape and function.

In an exclusive statement to Al Jazeera, Dagim explained that there are differences in the design, type and manufacturing methods of dental implants, which in turn can restore the patient's ability to chew food, as well as have a cosmetic effect. He is committed to providing the best smile shape for his patients.

Al-Daghim explains that dentures can be used to completely replace missing teeth, partially replace missing teeth, and potentially all teeth, depending on the situation. Some are used to completely or partially replace a single tooth, some are used to replace a group of teeth, and sometimes in the case of complete loss, all teeth are replaced, which is called “full mouth rehabilitation.”

Al-Daghim said there are multiple treatment options for a single case, and the most appropriate one is chosen based on the patient's requirements and the patient's health and financial situation, some of which are fixed devices that the patient cannot remove. Some are removable.

In the past, dental implants made of plastic and acrylic materials were often used, some of which were made of precious metals such as gold, silver, platinum and a mixture of several different metals, so they have some properties, including hardness and resistance to decay, but their shape and appearance usually cannot imitate the natural and aesthetic shape of teeth.

Modern Materials

He added that many modern materials for dental implants have been introduced that now have physical properties close to those of natural teeth and also mimic the shape, color and function of ceramic crowns and bridges. Glass, ceramic materials and metals such as zirconia provide us with excellent options for compensatory treatment and beautify teeth without affecting the important natural and aesthetic appearance.

Al-Daghim explains that preparing a tooth to receive a fixed implant is done by removing a small portion of the tooth, a process called “tooth preparation.” The amount of preparation depends on the type of material used and its purpose. In some cases, the preparation is only a fraction of a millimeter. Afterwards, the doctor takes measurements and sends them to a dental laboratory to make the fitting, which is then cemented into the patient's mouth.

Al-Daghim concluded by stressing the importance of caring for dental implants once they are installed, including regular brushing, flossing and rinsing, as they must be cared for like natural teeth.

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