Dental Care

Coronal Leakage?


What is coronal leakage? Each person hopes that once he's undergone a root canal procedure, he won't have to anticipate any additional problems.

But it's possible to experience complications afterwards.  It means that the longevity of your tooth might be in danger. 

In other articles, you've learned about the process of contamination within the pulp and root canals of a tooth that can lead to the need for a root canal procedure

You know that in most cases the root canal eliminates inflamed nerve tissue, bacteria, and compromised organic material within the tooth. 

In some cases, over a long period of time, a root canal treatment can fail.  Bacteria can leak back into the interior of your tooth and allow a new infection to develop. 

When this leakage comes from the top of the tooth rather than the root, it's called coronal leakage.  The word "coronal" refers to the crown of the tooth.

Only about five to ten percent of root canals fail -and coronal leakage occurs in just a small percentage of those cases.  Rest assured that the number of people who experience it is really very small. 

It doesn't necessarily take long for recontamination to take place.  Dentists have studied how and why it happens.  Dyes placed on top of temporary sealing materials were able to leak into the tooth within a matter of three days. 

And when bacteria within the patient's saliva were studied in research projects, they made it into the tooth within a month. 

Why Does Coronal Leakage Take Place? 

Dentists have been performing root canals for a long time.  Past research has focused predominantly on how best to perform the obturation

That's the part of the root canal that takes place after the dentist has cleaned out the offending tooth pulp and shaped the interior of the tooth.  When he's finished with that, he sterilizes and dries out the tooth interior; only then does he get to the obturation. 

In the past, once the tooth was filled with the new material, covering it over seemed to be the least of the dentist's work.  But over time, dental researchers have paid more attention to complications arising from problems with the obturation process. 

Studies have shown that complications do arise from the inadequate filling or sealing of a treated tooth. 

The most common one occurs when there is a delay between the time when the dentist prepares the tooth and the time when he actually fills and seals it.  There are, however, about a half dozen factors contributing to the problem of coronal leakage:

  • Sometimes the dentist does not study the tooth adequately before he treats it. Miniscule root canals within the tooth or tiny cracks on its surface remain unnoticed. It's also important for the dentist to be certain there will be enough tooth rising above the gum line to sustain a proper seal.
  • Sometimes the dentist does not clean out the interior aspect of the tooth thoroughly. If he does not shape the interior properly, the material he fills the tooth with will not obturate it -close it up- properly.
  • If a temporary filling is installed, an antibacterial medication should be used to prohibit growth. The thickness of the temporary filling is also important in precluding leakage into the vulnerable tooth.
  • Problems can occur when the tooth post is prepared or inserted. If the post is too wide for the tooth or if it does not rest solidly within the tooth, it can lead to coronal leakage problems.
  • The dentist must use the proper type of bonding material for the post used. He should not use a glass or resin-glass bonding agent for cementing posts; he should be certain to choose something that bonds well with the tooth's dentin.
  • After the seal is placed, the dentist should be certain that the patient's natural bite is restored. If there is trauma when the patient's teeth come together, the integrity of the dental seal will be breached.


Don't be afraid to talk to your dentist about the seal he will use on your tooth. 

Ask if there is enough tooth left for an effective seal, and inquire if the sealing material will bond well with the other parts of your tooth. 

Don't approach a root canal with the fear that this is almost certainly going to happen in your case.  Coronal leakage, overall, remains a relative rare complication. 

 

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