WHAT TREATMENT SHOULD YOU CHOOSE ? -Root canal therapy , bridge/crown or dental implants

The most common reason for a patient to report for dental opinion is either due to pain or for wanting to replace a missing tooth. This blog would give you an overview of the various treatment options available and the right indication to choose the most evidence based, appropriate and ethical option available.

Root canal therapy (RCT)

When the bacteria causing dental caries infects the tooth’s nerve and pulp tissue, the patient experiences pain and then the primary choice of treatment should be Root canal therapy. The decision is made by the dentist considering several factors such as condition of the remaining tooth structure, extent of  the infection in the surrounding bone, gum health and the strength of the supporting bone.

In a Root canal therapy, the infected nerve and pulp tissue is removed. The root canals are cleaned and shaped so that the infection is completely removed and the root canals are disinfected. The canals are filled and sealed using special biocompatible filling material. To fully restore the normal function of the tooth, a protective coverage/crown that completely surrounds the tooth is given to protect the remaining tooth structure. Thus a RCT saves the tooth while the full coverage crown brings it back to functional harmony.

Dental Implants

If the tooth is beyond repair, the only choice of treatment is to extract the tooth. The best way of fixed replacement of a lost tooth is by placing dental implants. Dental implants are made of pure titanium which when placed into the bone would totally integrate and become a part of human body over a period of time. After the healing period varying from 3-5 months, a crown on top of the implant is placed after which the implant supported crown becomes fully functional. We would require you to take a 3-D CBCT scan to assess the bone density. This give us the best possible information regarding the most appropriate size and depth of implant that would suit the particular region.

The procedure itself is a simple, painless single visit that would involve placing a root form implant followed by resorbable sutures. The post- operative healing involves avoiding hot and spicy food for the first 48 hours. You can go back to normal work routine after 24 hours itself. We would be giving you medications for 3-5 days to ensure appropriate healing.

Our centre recommends implant loading after a period of 3-5 months. This decision is based on the density of your bone that we ascertain with the pre-operative CBCT scan. After this period we place a crown on top of the implant by making a mould and custom processing the crown.

Fixed partial denture (FPD) or Bridge

The other traditional method to replace a missing tooth is by giving fixed prosthesis or commonly called as bridges or crowns. A fixed Prosthesis is a restoration to fill the space where one or more teeth are missing. A fixed bridge is permanently cemented into place over the prepared teeth on either side of the missing tooth. The bridge is fabricated from a dental impression by the dental lab in all porcelain or porcelain fused to metal matching the color of your existing teeth.

The success rate of  Root canal therapy, fixed prosthesis and dental implants are almost the same. Although  chronic smokers, uncontrolled diabetic patients and individuals suffering from any immune compromised condition are prone to experience complications in the case of dental implants. A root canal therapy  is vastly recommended for such individuals.