Root canal treatment complications - Coronal leakage.

What is it?

In short, coronal leakage refers to the phenomenon where bacteria and other contaminates find a way to seep past a tooth's dental restoration.

Ultimately, this recontamination of the tooth's interior can result in the failure of the root canal treatment it's received. (Our video "What's the purpose of root canal treatment?" explains why.)

How is it prevented?

After viewing our video, you'll understand why the long-term success of root canal therapy depends on more than just the expertise with which the tooth's work has been performed.

It's also dependent upon the seal that's created by the dental restoration that's placed on the tooth after its procedure has been completed.

FYI: The restoration that's placed after root canal treatment needs to be one that can create a substantial barrier to any contaminates trying to re-enter the tooth. It also needs to be a durable enough that it can be expected to maintain this seal over the long-haul.

In regards to preventing coronal leakage, dental crowns have a reputation for creating a lasting seal. Dental fillings can too in some instances. You'll simply have to rely on your dentist's judgment about what type of restoration is best for your situation.

FYI: You'll also need to quiz your dentist about the time frame in which your tooth's permanent restoration should be placed.

At the completion of your tooth's root canal treatment, your dentist will probably just place a temporary filling. Over time, this restoration and its seal will deteriorate.

Your goal should be to have it replaced with a permanent restoration (filling or crown) long before the complication of coronal leakage becomes an issue.

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Video transcript -

Title: Coronal Leakage - A root canal treatment complication. How the right type of dental restoration helps to prevent it.

Two major tasks accomplished during root canal treatment are cleansing the "nerve" space that lies inside the tooth. And then, filling in and sealing off this cleansed space so to make it difficult for debris and bacteria to re-enter and re-colonize this area.

Beyond this first seal that's created during the root canal process, there's yet a second seal that plays an important role in the long-term success of a tooth's treatment. That's the seal created by the dental restoration that's placed that both restores the tooth to its original shape and fills in the access cavity through which the dentist performed their work.

The need for this seal is as follows: A person's mouth contains bacteria and assorted debris. And if these items are successful in seeping past the dental restoration that's been placed in the tooth's access cavity, the likely result will be the recontamination of the tooth's root canal system and, ultimately, the failure of the tooth's root canal treatment.

Dentist use the term "coronal leakage" when referring to this phenomenon. And after completing a tooth's therapy, they must make a determination about what type of restoration seems best suited for preventing it, and the time frame during which this restoration should ideally be placed.

In those cases where it's just a matter of filling in a small, conservative access cavity, a regular dental filling may suffice.

However, in those situations where treatment has been performed for a tooth that already has a sizable filling, or a significant amount of decay, a filling may not be the best choice. Comparatively large fillings are more likely to fail over the long-term and they don't have the ability to protect a tooth as fully as some other types of dental restorations. Clearly, if a tooth or its restoration experiences problems, the likelihood of the tooth experiencing coronal leakage increases.

So, for these situations where the needed restoration must replace a substantial amount of missing tooth structure, a dental crown is typically the best choice. This is especially true for teeth (like molars) that must withstand heavy chewing forces.

Dental crowns provide excellent protection for teeth. And the nature of their design creates a substantial barrier to coronal leakage. Additionally, they are typically long-lasting restorations that can be expected to maintain their integrity, including their seal, over the long-haul.

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