Tooth discoloration after root canal?

[toysareus]

Why is it that after a root canal is done, the tooth becomes discolored?
Also, does this always happen?

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[gpg]

The discolouration is always due to the pigment Hemosiderin, a by-product of haemoglobin.

If a vital tooth receives a blow strong enough to cause pulpal death,the blood recomposesand Hb gets converted to Haemosiderin which enters the dentinal tubules and causes the typical black discolouration associated with non-vital teeth after trauma.

similarly,after a root canal, if the biomech is not done well and insufficient usage of irrigants like hypochlorite and hydrogen peroxide,the same flows into the tubules and a tooth which looked normal suddenly looks black AFTER root canal.

To prevent the same:
1)proper antibiotics and anti-inflammatory before RC opening and biomech.
2)Clean and shape the canals really well.
3)Copious use of Hypchlorite and peroxide,with last one used being hypo,else peroxide will release nascent O2 causing pressure build up.

In case it does happen,
1)Preferably a ceramic/PFM crown will be the best option.Good esthetics and protects the tooth struc.
2)If not poss,then direct composite/indirect ceramic venner.But only after proper bleaching......either office bleach or walking bleach.Trouble is bleaching has to be re-done in 6 months and then the pt is not too happy.

Hope this solves ur doubts!

 

[no2thdk999]

The discolouration is always due to the pigment Hemosiderin, a by-product of haemoglobin.

If a vital tooth receives a blow strong enough to cause pulpal death,the blood recomposesand Hb gets converted to Haemosiderin which enters the dentinal tubules and causes the typical black discolouration associated with non-vital teeth after trauma.

similarly,after a root canal, if the biomech is not done well and insufficient usage of irrigants like hypochlorite and hydrogen peroxide,the same flows into the tubules and a tooth which looked normal suddenly looks black AFTER root canal.

To prevent the same:
1)proper antibiotics and anti-inflammatory before RC opening and biomech.
2)Clean and shape the canals really well.
3)Copious use of Hypchlorite and peroxide,with last one used being hypo,else peroxide will release nascent O2 causing pressure build up.

I'll buy the part about a vital tooth changing colors due to the hemosiderin breakdown but often the dark color will fade in a primary tooth as the body breaks it down. But with a tooth that has endured root canal therapy the color change is usually due to the use of a sealer containing eugenol. This can be prevented by removing the gutta percha and sealer to below the crest of bone and sealing the tooth with resin.

I'll argue the need for antibiotics and anti-inflammatories prior to all RCT. Hydrogen peroxide is an OK irrigant but there are better choices that make it unnecessary IMHO.

Rob

 

[toysareus]

Thanks everyone
Any other thoughts on why the tooth becomes discolored?
Also, why does the tooth weaken after a root canal?

 

[lnn2]

.....a tooth that has endured root canal therapy the color change is usually due to the use of a sealer containing eugenol. This can be prevented by removing the gutta percha and sealer to below the crest of bone and sealing the tooth with resin.

I'll argue the need for antibiotics and anti-inflammatories prior to all RCT. Hydrogen peroxide is an OK irrigant but there are better choices that make it unnecessary IMHO.

Rob

I agree! An intrinsic discoloration of a tooth is due to pupal hemorrhage into the dentinal tubules (due to traumatic injury of the tooth,) or from the use of medications that cause staining when used in RCT, such as eugenol, formocresol, root canal sealers, and some antimicrobial pastes. Pins, glass ionomer , even composites can leave a gray color around it over time. Amalgam restorations can leave gray black color in the tooth.

Antibiotics are not given prior to all RCT unless med. hx. condition indicates so. Antibiotics after RCT is not necessary according to the Endo textbook that we studied.

"A tooth weaken after RCT" The pulp layer of the tooth contains the nerves and blood supply for the tooth. Tooth becomes dry and brittle after the nerve is removed (RCT). Also, the amount of decay and the hole that is opened in the tooth for removing the pulp may weaken the tooth.