Integrative Endodontics uses state-of-the-art techniques to help your teeth regenerate damaged structures in the treatment of deep cavities. As teeth heal, the roots and nerves function optimally again so your natural teeth and smile can be saved.
Among natural alternatives to root canal treatment, we have found that regenerative endodontics and vital pulp therapy (VPT) are a promising route. Regenerative techniques are not always an alternative to root canal therapy (RCT), yet they can be in some cases, when the diagnosis is still in a reversible stage of inflammation.
To revitalize the tooth, our doctors perform many indirect pulp caps, which can treat deep cavities and preserve the pulp, which contains the tooth’s nerves and blood vessels. This treatment stimulates a process called dentinogenesis, in which the tooth begins to heal itself. It can grow new tooth structure over the affected area, which may have been injured.
As part of our regenerative endodontic services, we provide the following:
Indirect pulp caps
Direct pulp caps
To treat these deep cavities, we use VPT in conjunction with laser and ozone therapy inside the tooth. We call this signature process EndOzLase™, and we use it in both our VPT and RCT processes. In VPT, the laser gently removes deeper decay, preserving the integrity of the pulp and disinfecting the dentin. The subsequent ozone treatment opens and disinfects the dentinal tubules, allowing further penetration of the biocompatible materials, which are designed to support the tooth’s remineralization process.
A 14-year-old boy came into Integrative Endodontics with a large cavity in his lower-right molar. He had no history of symptoms, which is ideal for successful vital pulp therapy (VPT).
The initial radiograph (X-ray image) shows the decay. You can also see slight swelling in the periodontal ligament, which is located at the tip of the root.
14 year old with decay extending into the pulp.
Minor swelling in the Periodontal Ligament shows Inflammation has reached the radicular pulp and surrounding tissues.
A 6-month recall after EndOzlase pulpotomy performed showed regeneration of the Periodontal Ligament.
After isolating the tooth to avoid contamination, the laser was used to remove the decay and bacteria trapped in the dentinal tubules. In this case, the bacterial infiltration had already created irreversible damage to the coronal pulp.
A pulpotomy procedure was performed with the laser to selectively remove the inflamed tissue. Once healthy tissue was identified, gentle ozone therapy1 was performed to stimulate the microcirculation of blood within the pulp.
Next, a biocompatible material was placed, which facilitates a mineralized barrier formation at the interface with the pulp tissue. The osteoinductive properties of bioceramics help to create a framework for new dentin formation, as well as preventing bacterial adherence.
1 Shilpa, Reddy A et al. “Role of Ozone Therapy in Minimal Intervention Dentistry and Endodontics – A Review.” Published online 2013 Jun 23. Accessed 2021 Mar 8. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3769872/
To monitor progress and healing, we asked the patient to return for new radiography. This recall image shows the periodontal ligament regenerated, returning to its normal shape and size at the apex of the root.
“My family and I have nothing but amazing things to say about Dr. Kanter. As the father of 7 children and a lifelong believer in the power of holistic medicine, I was terrified at the idea of my youngest son needing a root canal. I was told that there may not be any other options to save his tooth, as the decay had begun to enter his gums. I was then advised by LA holistic Dentistry to speak with Dr. Kanter. Dr. Kanter took the time to sit with me and discuss, in detail, possible alternatives to a root canal. She mentioned a novel procedure called a pulp cap/vital pulp therapy. She made sure to explain all of the steps of the procedure and I felt nothing but confident in agreeing to let her do one on my son’s tooth.The results were amazing and not only did she save my son from having to get a root canal, he is also completely free of any pain. Thank you so much, Dr. Kanter for being such an incredible dentist and person.”
– Andy Lodi
Read Dr. Val’s insights on Platelet-Rich Fibrin.
Resources: Regenerative Endodontic Therapy: The Fountain of Youth for a Dying Tooth, Dr. Valerie Kanter, IABDM; and Fillings That Heal Your Teeth, The University of Nottingham.