Endodontics has undergone some massive changes within the last few decades. By introducing newer bonding materials, irrigation systems, and rotary tools, endodontists can meet the demands of more complex cases and improve their practices. But patients these days are now looking to dentists for more fully-encompassed restorations, often seeking out dentists with more than one specialty to resolve their health issues. It’s considered pretty rare to find a dentist with a singular background, as most patients these days require treatments customized to their needs.
One of the biggest demands that endodontists face is restorative treatments. Most patients often go to their general dentist or cosmetic dentist to receive treatments. Still, in cases of more complex problems, some endodontists have taken up the mantle of combining their fields of work with restorative procedures. Restorative Endodontics is a new field combining the best of both worlds.
Why Restorations and Endodontics Work Well Together
More patients are looking for multi-disciplined dentists. Endodontists need to evolve their brand of dentistry to meet these demands. Aesthetics, in particular, has become more of a concern over the last few decades as dentistry shifts from its previous functional concerns. Advancements in technology have helped make this possible, and aesthetics is becoming even more popular among younger generations. Incorporating restorative techniques into endodontic procedures seems like a perfect response to this shift in dentistry, but does it work?
Restorative Endodontics is a new type of discipline, focusing on conservative techniques and restorative methods to cure ailments. Although not as well cited, endodontics and restorative dentistry are the perfect combinations because they focus on preservation and aesthetics in a clinical setting. For instance, treatments such as root canals often result in excessive tooth removal, which can typically increase the risk of endodontic failures and retreatments. Preserving the inner dentin and pulp is the primary focus of any dentist. Still, even with conservative measures, some patients may face issues with the anterior teeth that may lead to the loss of their tooth’s natural shape during the process.
Restorative dentistry typically handles the aesthetic side of things, working to reinforce the teeth with prosthetic devices such as crowns, bridges, and veneers. However, restorations typically don’t focus on conservation, often working with complete tooth extractions and excessive enamel removal to restore the tooth. But the lack of focus on natural preservation tends to leave many patients faced with the loss of their natural tooth, and complex tooth cases often tend to leave patients without the option for conservative methods.
These issues outlined tend to be often overlooked, but with restorative endodontics, endodontists can work with restorative methods to not only improve the tooth aesthetically but assure that the root canal is protected from bacteria growth. But even this field is subject to failure if those treatments aren’t properly executed. In fact, improper use of restorative techniques can lead to endodontic failures; problems such as improper cleanings, insufficient preparation methods, and poor removal of tooth structure can lead to significant damage to the affected tooth and even further emphasize those issues. But finely balancing the techniques available from both fields creates a way to completely address complex tooth problems without resorting to excessive means of tooth removal.
What Kinds of Restorative Methods Work With Endodontics?
Because of the various obstacles that come with complex tooth restorations, endodontically-prepared teeth need special consideration to help reinforce and repair signs of loss of integrity and complex tooth decay. In order to help patients meet the requirements for healthy tooth care and incorporate aesthetics, endodontists must develop new ways to approach the restorative process typically used by their peers. Within the last few years, there have been numerous techniques have developed to approach these issues, including:
- EndoCrowns: Endodontic crowns are a new type of restorative that helps patients faced with a large loss of coronal structure. These crowns help reinforce the pulp chamber through adhesive materials, and as an alternative to traditional crowns, it helps preserve the remaining inner dentin and pulp.
- Fiberglass Composite Restorations: Fiberglass has been looked at over the last few decades as a way to provide better adhesion to the dentin and pulp layers. Researchers looking into the use of fiberglass have found that in some cases, it’s reported to be better than composite resin, metal, and zirconia restorations.
- Post-And-Core Restorations: Post and core techniques work to help rebuild the inner workings of the tooth from the ground up, using resin posts to provide internal support for the remaining tooth while using core buildup to protect the post. They’re typically used to anchor crowns after extensive pulp removal and have been able to help eliminate the need for full tooth extractions.
- Dental Air-Abrasion Techniques: This technique provides a narrow stream of aluminum-oxide particles to remove small amounts of dentin without the need for heat, noise, and vibration. As a rising trend, many patients have reported a positive experience from their visits from this technique which helps conserve dentin more accurately.
- Bulk-Fill Adhesive Materials: Bulk-fil is a standard method for preparing restorations such as crowns. Endodontists and restorative dentists can use bulk-fill adhesives as an alternative to other bonding materials.
- Light Curing Regimes: Light-curing regiments are also used to strengthen the bond between materials. Light curing devices provide more accurate curing times for endodontists working with restorative methods, allowing for an easy bond with the dentin layer. These devices also allow for more accurate results because these devices can adjust for angles and air-cooling techniques, helping protect the tooth in the process.
While this small list can help further blend the two specialties together, there are numerous requirements both endodontists and restorative dentists must meet to be able to make these fields of dentistry work. In order to resolve this conflict, improvements in shaping, obturation, and material usage are needed to establish a better relationship between these two fields. From this development, we can hopefully make this subspecialty more popular among patients and find a unique system that works for everyone.
