calcified canal

[marimo]

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why is the root canal calcified? is it due to aging? if so, means teenager wouldn't get calcified canal?

 

[DentinBond]

Good question.

Throughout life the pulp cells lay down more dentin at a very slow rate. The pulp starts to form this "secondary dentin" just after root formation is complete.
"Tertiary dentin" is formed in response to irritating stimuli like caries, trauma and even periodontitis. It forms faster than secondary dentin and has a more irregular pattern of tubules and cellular inclusions.

Thus, secondary dentin would just be getting started in its formation in teenagers, and is normally negligible at that age. But tertiary dentin could certainly be found in teens. Caries and sports injuries affect this age group a great deal!

When performing endodontic treatment, always remember-- the calcification tends to be worst at the occlusal/incisal. You can see this on radiographs. I use a surgical operating microscope now, but even so, there are calcified canals that are difficult to find. But there they are, on the pre-op X-rays, mocking me with their crisp darkness, just a millimeter further towards the apex from where my bur is now...
The thing is to use color differences and tactile sense with a sharp endo explorer to access the canals with precision and not perforate the floor of the chamber, or perforate laterally. A surgical operating microscope makes this an enjoyable challenge, where working with regular vision the process was always a frightening mess.

Couple of posts on this. Written for patients, but the science is there.

http://rickwilsondmd.typepad.com/rick_wilson_dmds_blog/2010/09/dental-pulp-calcification-spelunking-in-the-dentin.html

http://rickwilsondmd.typepad.com/rick_wilson_dmds_blog/2011/01/dental-pulp-calcification-and-changes-with-age.html

 

[marimo]

Good question.

Throughout life the pulp cells lay down more dentin at a very slow rate. The pulp starts to form this "secondary dentin" just after root formation is complete.
"Tertiary dentin" is formed in response to irritating stimuli like caries, trauma and even periodontitis. It forms faster than secondary dentin and has a more irregular pattern of tubules and cellular inclusions.

Thus, secondary dentin would just be getting started in its formation in teenagers, and is normally negligible at that age. But tertiary dentin could certainly be found in teens. Caries and sports injuries affect this age group a great deal!

When performing endodontic treatment, always remember-- the calcification tends to be worst at the occlusal/incisal. You can see this on radiographs. I use a surgical operating microscope now, but even so, there are calcified canals that are difficult to find. But there they are, on the pre-op X-rays, mocking me with their crisp darkness, just a millimeter further towards the apex from where my bur is now...
The thing is to use color differences and tactile sense with a sharp endo explorer to access the canals with precision and not perforate the floor of the chamber, or perforate laterally. A surgical operating microscope makes this an enjoyable challenge, where working with regular vision the process was always a frightening mess.

Couple of posts on this. Written for patients, but the science is there.

http://rickwilsondmd.typepad.com/rick_wilson_dmds_blog/2010/09/dental-pulp-calcification-spelunking-in-the-dentin.html

http://rickwilsondmd.typepad.com/rick_wilson_dmds_blog/2011/01/dental-pulp-calcification-and-changes-with-age.html

so calcified canal still got any bacteria which require rct?

 

[DentinBond]

so calcified canal still got any bacteria which require rct?

Regrettably, yes.
The canals certainly do not become solid blocks of calcium. I dearly wish they did. It's more like a dense net of irregular dentin and lacunae of connective tissue.
And anaerobes.

Fascinating to me is the fact that the human root canal system always, given time, selects out for the same few anaerobic bacterial species. There are probably a number of different lists that researchers come up with, depending on methodology, but here's a reasonable one:
"The mean bacterial count (CFU) in root canals was (range ), and anaerobic bacteria were predominant (89.8%). The predominant isolates were Olsenella (25.4%), Mogibacterium (17.7%), Pseudoramibacter (17.7%), Propionibacterium (11.9%) and Parvimonas (5.9%)."

From http://www.hindawi.com/journals/ijd/2012/609689/

Hey-- It always helps to know your enemy.

 

[marimo]

Regrettably, yes.
The canals certainly do not become solid blocks of calcium. I dearly wish they did. It's more like a dense net of irregular dentin and lacunae of connective tissue.
And anaerobes.

Fascinating to me is the fact that the human root canal system always, given time, selects out for the same few anaerobic bacterial species. There are probably a number of different lists that researchers come up with, depending on methodology, but here's a reasonable one:
"The mean bacterial count (CFU) in root canals was (range ), and anaerobic bacteria were predominant (89.8%). The predominant isolates were Olsenella (25.4%), Mogibacterium (17.7%), Pseudoramibacter (17.7%), Propionibacterium (11.9%) and Parvimonas (5.9%)."

From http://www.hindawi.com/journals/ijd/2012/609689/

Hey-- It always helps to know your enemy.

ok, thank you so much 🙂