Traumatic Injuries to the Mouth
Dislodged Teeth
Mouth injuries can force teeth backward into their sockets. Dr. Kan or your general dentist may reposition and secure your tooth in place. Root canal therapy typically begins within a few weeks following the trauma, and a therapeutic medication like calcium hydroxide will be placed within the tooth. Later, a permanent root canal filling will be completed.
In some cases, a tooth may be pushed partially from its socket. Your endodontist or general dentist can reposition and stabilize the tooth. When the pulp stays healthy, no additional treatment is needed. However, if the pulp becomes damaged or infected, root canal therapy becomes necessary. Without proper treatment, several complications may develop. These complications can include but are not limited to: infection of the tooth, root structure or surrounding tissues, poor oral hygiene due to difficulty properly cleaning the displaced tooth and gums, and potential tooth loss.
Avulsed Teeth
When an injury causes a tooth to be completely knocked from your mouth, immediate treatment is critical! If this occurs, keep the tooth moist at all times. When possible, place it back into the socket. A tooth can be preserved if it stays moist. You can place the tooth in milk or a glass of water (add a small amount of salt.) Dr. Kan may begin root canal therapy depending on the stage of root development. How long the tooth was outside your mouth and the storage method used may determine the type of treatment you receive.
Tooth Injuries in Children
An injured developing tooth may require one of the following procedures to improve the likelihood of preserving the tooth:
Apexogenesis
This procedure promotes continued root development while the pulp heals. Soft tissue receives medication to stimulate growth. The root tip (apex) will continue to close as the child matures. The root canal walls will also thicken during this process. When the pulp heals successfully, no further treatment is needed. The more developed the root becomes, the greater the chance of saving the tooth.
Apexification
In this situation, the damaged pulp is removed. Doctors place medication into the root to promote hard tissue formation near the root tip. This hardened tissue creates a barrier for the root canal filling. The root canal walls will not continue developing at this point, making the tooth more prone to fractures. Proper restoration by your dentist becomes important for long-term success.
Regenerative Procedures
Regenerative endodontic procedures (REPs) aim to replace damaged pulp tissue with healthy, vital tissue in immature permanent teeth with necrotic pulps. Key techniques include revascularization (pulp revascularization), pulp implantation, and scaffold-based approaches. The most common protocol involves minimal instrumentation, disinfection with triple antibiotic paste or calcium hydroxide, induction of bleeding to form a blood clot scaffold, and coronal sealing with MTA and composite.
Outcomes include continued root development, increased dentin wall thickness, and apical closure. True pulp regeneration with organized odontoblasts and nerves remains limited; most cases show repair with cementum-like or bone-like tissue. Success depends on strict asepsis and case selection.