At Smile Solutions Dr Gregory Tilley 
(a highly experienced registered specialist endodontist), Dr Chankhrit Sathorn 
(a registered specialist endodontist with a PhD in the field) and Dr Artika Soma
(a registered specialist endodontist) will care for all your root canal related treatment requirements.
Inflamed Teeth
A damaged tooth that has inflammation of the pulp (nerve) can be acutely painful for the patient and can only improve with professional treatment.
How we can help
Often, the patient can be distressed and in considerable pain. By ensuring a prompt response from one of our expert root canal specialists, we can relieve the stress for both the patient and the referrer.
What we do
Treatment is geared towards removal of the inflamed tissue, full preparation of the canal systems and full obturation, ensuring that, combined with a good crown or filling, bacteria can be prevented from multiplying in the canal spaces. Prognosis in this instance is usually very good and success rates of 95% are not unusual.
Infected Teeth
The situation can be worse if the nerve or a blood vessel has disintegrated and bacteria have colonised the root canal system. This can lead to abscess formation, with the bacteria sending toxins right into the jaw bone.
How we can help
With the use of the most modern equipment, microscopes, nickel titanium files and ultrasonic activated irrigant systems, we can make sure the canals are as clean as possible. We then seal them with thermo-plasticised gutta-percha to ensure a three-dimensional seal.
What we do
Treatment is more demanding where infection is present, as it then involves cleaning the contaminated root canal system of all bacteria. Canals are complex, three-dimensional spaces where absolute sterility will not occur, so the aim of sealing the canals is to trap any remaining bacteria and prevent any nutrients getting to them so that they will no longer be viable.
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Before After |
Even with the most advanced and efficient mechanical equipment, it is impossible to get rid of all the bacteria, so we employ various irrigants to further cleanse the canals and increase the chances of a successful first-time treatment.
As long as there are no fresh sources of leakage and the tooth is well sealed, a very high success rate of about 90% can be expected.
Re-Treatments
If previous treatment has not achieved satisfactory results, or the canals have become reinfected, a further attempt can be made to cleanse the canals and re-treat the tooth. Teeth involved in re-treatments are more complicated to disinfect and often require the removal of any obstructions to the canal.
How we can help
Using our thorough knowledge of canal anatomy, specialist techniques and equipment (digital radiographs and vision-enhancing microscopes), we can remove problems like posts and separated instruments, avoiding surgery whenever possible. To give careful and optimal treatment we can assess whether there are extra canals that may have previously been missed. We can also check any further factors that may compromise the tooth, such as perforations and fractures, and advise the patient accordingly so that they do not undergo treatment with a poor prognosis.
What we do
Re-treatment may require post removal and removal of the original root filling. This in itself can be quite time-consuming, and different irrigants need to be used to counter specific bacteria known to contribute to failure. The success rates for re-treatment tend to be not quite as good, but a rate of around 70% can still be achieved – certainly a viable alternative to extraction.
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Before After |
Surgical Treatment
Occasionally surgery has to be undertaken to rectify any errors or to clean an inaccessible portion of a tooth.
How we can help
We will thoroughly assess the causes of failure and will perform surgery only if it is the best option. Using microsurgery techniques, ultrasonics and biocompatible materials, we will try to make the outcome of any surgery as predictable as possible.
What we do
With the modern techniques we employ, we often can avoid all surgical treatment by first re-treating the tooth – and this is usually our first option. However, there are specific indications for surgery; these include avoiding damage to a new post crown or if there is an untreated portion of root not amenable to routine cleansing. In these cases we perform surgery if it has a good prognosis.
*These X-ray images feature Smile Solutions patients. They are simply an educational guide and by no means represent a guarantee of outcome.
