Everything I've read about root canals says that the entire root is
removed and replaced with gutta percha. But I would naively think that
if only the upper portion of the root is infected, or there is no
infection at all but only pain, that just the upper portion of the
root could be removed instead, thereby leaving a stronger healthier
tooth. Is such a "partial root canal" ever done, and if not why not?

Thanks.

Everything I've read about root canals says that the entire root is
removed and replaced with gutta percha. But I would naively think that
if only the upper portion of the root is infected, or there is no
infection at all but only pain, that just the upper portion of the
root could be removed instead, thereby leaving a stronger healthier
tooth. Is such a "partial root canal" ever done, and if not why not?

Thanks.

John wrote:
Everything I've read about root canals says that the entire root is
removed and replaced with gutta percha. But I would naively think that
if only the upper portion of the root is infected, or there is no
infection at all but only pain, that just the upper portion of the
root could be removed instead, thereby leaving a stronger healthier
tooth. Is such a "partial root canal" ever done, and if not why not?

Thanks.


The traditional answer is that there is no such thing in legitimate
dentistry, with the exception that pulpotomy (removal of the pulp in the
chamber, usually followed by application of an antimicrobial agent) was
done as a temporary expedient.
Now, I'm starting to hear talk of direct pulp caps and even partial
pulpectomies, usually involving the use of an agent known as MTA.
In other words, this is an interesting area of endodontia in which the
traditional thinking may have to change.

Steve

On 2 Feb 2007 07:50:41 -0800, "John" <allen...@mail.northgrum.com> wrote:

Everything I've read about root canals says that the entire root is
removed and replaced with gutta percha. But I would naively think that
if only the upper portion of the root is infected, or there is no
infection at all but only pain, that just the upper portion of the
root could be removed instead, thereby leaving a stronger healthier
tooth. Is such a "partial root canal" ever done, and if not why not?

Thanks.

The root is not removed, the contents of the root canal are removed
and sealed with GP plus a sealant in most cases.

Partial RCT's are not done in adults because once the pulp
becomes infected ultimately it will die.

Pulpotomy is done on primary teeth but that is another animal entirely.

On Feb 2, 3:21 pm, Newbie <n...@bix.nex> wrote:

On 2 Feb 2007 07:50:41 -0800, "John" <allen...@mail.northgrum.com> wrote:


Everything I've read about root canals says that the entire root is
removed and replaced with gutta percha. But I would naively think that
if only the upper portion of the root is infected, or there is no
infection at all but only pain, that just the upper portion of the
root could be removed instead, thereby leaving a stronger healthier
tooth. Is such a "partial root canal" ever done, and if not why not?

Thanks.

The root is not removed, the contents of the root canal are removed
and sealed with GP plus a sealant in most cases.


I use the terms "root", "pulp" and "nerve" interchangeably. So, I
think of the "root canal" as the entire root content of the tooth.
And I understood "root canal therapy" to mean the removal of the
entire root, aka a "pulpectomy".


Partial RCT's are not done in adults because once the pulp
becomes infected ultimately it will die.


Why can't only the infected pulp be removed, leaving health pulp? Is
it because it is difficult to tell infected from non-infected? What
if there is only pain, but no sign of infection? Say the pulp nearest
to a filling has become sensitive through repeated trauma. Why can't
only it be removed leaving healthy pulp beneath it?


Pulpotomy is done on primary teeth but that is another animal entirely.


So, "pulpotomy" seems to be partial removal of the root (pulp). My
question was why is this never considered an option for adult teeth?
(though from Steven Bornfeld's response, it seems to be a current area
of research).

BTW, I found a great site for information about teeth and dentistry.
It's http://www.doctorspiller.com/. To my layman's mind, it's
remarkably comprehensive and accurate. He mentions primary (baby)
tooth pulpotomy and an adult tooth pulp cap, but not adult tooth
pulpotomy, here: http://www.doctorspiller.com/Children's
%20Dentistry.htm#pulpotomy

Why can't only the infected pulp be removed, leaving health pulp? Is
it because it is difficult to tell infected from non-infected? What
if there is only pain, but no sign of infection? Say the pulp nearest
to a filling has become sensitive through repeated trauma. Why can't
only it be removed leaving healthy pulp beneath it?

John wrote:

Why can't only the infected pulp be removed, leaving health pulp? Is
it because it is difficult to tell infected from non-infected? What
if there is only pain, but no sign of infection? Say the pulp nearest
to a filling has become sensitive through repeated trauma. Why can't
only it be removed leaving healthy pulp beneath it?


So far, the type of tissue damage associated with partial removal
of the pulp, seems to inflame/contaminate/doom the rest of the
tissue.

One theory that I've heard.......

In other parts of the body, wounded tissue is surrounded on almost
all sides by healthy tissue, and healing begins on many fronts.

The canal space in a tooth is only entered through a tiny opening
at the apex (roughly the size of one human hair). It restricts the
access of healing chemicals and cells into the area of damage.

It may also have something to do with the inflammatory response of the
pulp tissue complicating normal blood circulation within the tooth
through this small entrance/exit.

No blood=dead tissue.

At any rate, failing to perform a complete debridement and fill usually
ends in failure. I can't say it will never work, but it doesn't work
now.

D