Endodontic treatment

When the tooth is affected with endodontic disease, either due to fracture or periodontal trauma, treatment is required. Endodontic treatment is an alternative to extraction of the tooth and will preserve the tooth.

Depending on the clinical and radiographic findings, there are different procedures that will preserve the endodontically compromised tooth.

Vital pulpectomy means that we only remove the most coronal portion of the affected dental pulp and cover it with medications to promote new dentin formation and hopefully preserve the tooth vitality. The procedure is performed as an emergency procedure within the first 48 hours after dental fracture, but this time may be prolonged in young animals with immature permanent teeth. It can also be performed as an elective procedure, when crown reduction is indicated. Success rate mostly varies with the type of the medication used (MTA shows superior results) and technique. Vital pulpectomy requires radiographic re-checks, usually 3-, 6- and 12 months after the procedure and then yearly thereafter to ensure continuous health of the tooth. However, nowadays vital pulpectomy is considered a temporary solution and is followed or replaced by a total pulpectomy (root canal treatment).

Root canal treatment describes the procedure, where the whole content of the root canal is removed, the canal shaped and cleaned and permanently obturated with a biologically inert material. Success of the treatment is high (about 80 – 90% for cats and dogs), but depends on pre-existing pathologies associated with endodontic disease and success of obturation of the root canal. Radiographic monitoring is required 3-, 6- and 12 months after the procedure and then yearly thereafter to assure success or healing. Persistent apical periodontitis (inflammation around the root apex) is possible and requires further treatment – either extraction or surgical endodontic procedure (apicoectomy).

Restoration is required for all endodontically-treated teeth. Similar restorative procedures may be employed to treat any dental defect that results from trauma, caries, or is developmental in origin.

If you have noted any problems with your animal, please consult your veterinarian.

Selected references
1. Fulton AJ, Fiani N, Arzi B, Lommer MJ, Kuntsi-Vaattovaara H, Verstraete FJ (2012). Outcome of surgical endodontic treatment in dogs: 15 cases (1995-2011). J Am Vet Med Assoc;241(12):1633-1638.
2. Kuntsi-Vaattovaara H1, Verstraete FJ, Kass PH (2002). Results of root canal treatment in dogs: 127 cases (1995-2000). J Am Vet Med Assoc;220(6):775-780.
3. Luotonen N, Kuntsi-Vaattovaara H, Sarkiala-Kessel E, Junnila JJ, Laitinen-Vapaavuori O, Verstraete FJ (2014). Vital pulp therapy in dogs: 190 cases (2001-2011). J Am Vet Med Assoc;244(4):449-459.
4. Niemiec BA (2001). Assessment of vital pulp therapy for nine complicated crown fractures and fifty-four crown reductions in dogs and cats. J Vet Dent;18(3):122-125.
5. Niemiec BA, Mulligan TW (2001). Vital pulp therapy. J Vet Dent ;18(3):154-156.
6. Strøm PC, Arzi B, Lommer MJ, Kuntsi H, Fulton Scanlan AJ, Kass PH, Verstraete FJM (2018). Radiographic outcome of root canal treatment of canine teeth in cats: 32 cases (1998-2016). J Am Vet Med Assoc;252(5):572-580.