Root canal involving a bridge?

This scenario happens quite offen.  A small hole is made in the bridge abutment and the tooth is accessed to locate the nerve.  Once the root canal is completed the hole that was made is filled with a filling material.  It should not damage the integrity of the crown in any way.

This sepends on whether a new bridge is being fabricated or a root canal is needed under an exisitng bridge.  If a root canal has to be performed and a new bridge being made, thenthe root canal is first then the bridge.  If a bridge exists and a root canal is required, then a hole is created at the top fo the tooth and a root canal is done throught this hole., The hole is then filled with a tooth colored restoration.  Typicaly no problems occur with either procedure although it is nice not to have a repair in the top of a porcelain restoration simply for integrity!

It can be a common procedure to perform a root canal on a tooth that is part of a bridge, without removing the bridge.  After the tooth is anesthetized, a hole can be made through the bridge to access the inside of the tooth.  Then the root canal procedure can be done.  After the root canal treatment is completed, the access hole can be filled with a restorative material.  

There are some circumstances where the bridge has to be replaced:


If there is porcelain on the bridge, it may fracture when the access hole is made, and a new bridge will have to be fabricated.  

Another situation that may occur is the bridge may have a cavity under it (a potential reason for needing a root canal) and to repair and access the cavity, the bridge will have to be cut off and remade.

This problem happens quite a bit in restorative dentistry and the process is as follows:

After the tooth is very numb and comfortable

1. Use of a fine diamond with lots of water is used to access the tooth and actually drill a hole through the crown and the actual tooth

2. The root canal system is entered and the procedure is completed

3. the access hole in the crown is filled with a composite resin or similar tooth colored restoration

4. The access could cause porcelain fracture or weakening of the tooth but if the tooth is infected the procedure must be done

5. Some dentists will like to place a post in the access but it may or may not help with tooth strength