What We Do


Sometimes root canal treatment is not indicated. During the consultation the preliminary diagnosis will be confirmed and the treatment options will be discussed. Any and all questions are welcome and will hopefully be answered during this appointment.

If your tooth is not amenable to endodontic treatment or the chance of success is unfavorable, you will be informed at the time of consultation visit.

Non-surgical endodontic therapy:

Injured pulp is removed by making a small opening in the top of the tooth and the root canal system is thoroughly cleaned and sealed. This treatment usually involves local anesthesia and may be completed in one or more visits depending on the treatment required. This will allow the tooth to function normally again.


Sometimes a tooth that has received treatment may fail to heal appropriately or pain may continue to exist. Sometimes, the pain may occur months or years after treatment. If so, endodontic retreatment may be indicated.

Improper healing may be caused by:

  • Curved or narrow canals not treated during the initial treatment.
  • Complicated canals undetected during the initial treatment.
  • The crown or restoration not placed within the appropriate amount of time following the procedure.
  • The crown or restoration failing to prevent saliva from contaminating the inside of the tooth.

In some cases, new problems can influence a tooth that was successfully treated to need to be treated again:

  • New decay exposing a root canal filling material, causing infection.
  • A cracked or loose filling or crown exposing the tooth to new infection.

Once retreatment has been selected as a solution to your tooth’s condition, it will be reopened to gain access to the root canal filling material. This restorative material will be removed to enable access to the root canal. The canal system will be thoroughly cleaned and carefully examined. Ultimately the canal system will be sealed and a temporary filling placed in the tooth.
At this point, you will need to return to your dentist as soon as possible in order to have a new crown or restoration placed on the tooth to restore full functionality.

Surgical endodontic therapy (apicoectomy):

Generally, root canal treatment is all that is needed to save teeth with injured pulp from extraction. Occasionally, this nonsurgical procedure will not be sufficient for complete healing to occur. In these instances, endodontic surgery may be recommended. Endodontic surgery is generally reserved to treatment challenges that were not or could not be addressed during nonsurgical treatment. Damaged root surfaces or the surrounding bone may also be treated with this procedure. The most common surgery used to save damaged teeth is an apicoectomy or root-end resection.

An incision is made in the gum tissue to expose the bone and surrounding inflamed and/or infected tissue. The damaged tissue is removed along with a small portion of the root tip. A root-end filling, or retrofill, is then placed into the root to prevent re-infection. The gum tissue is then sutured back into place. The bone naturally heals around the root over a period of months restoring full function and health.

Following the procedure, there may be some discomfort or slight swelling while the incision heals. This is normal for any surgical procedure. We will provide you with detailed post surgical instructions and will be available to assist you as needed.

Cracked Teeth:

Cracked teeth demonstrate many types of symptoms including pain when chewing and temperature sensitivity. It is also common for pain to come and go, making it difficult to diagnose the cause of discomfort.

Chewing can cause movement of the cracked pieces of your tooth, and the pulp within the tooth may become irritated. At the same time, when biting pressure is released, the crack can close quickly, resulting in sharp pain. Eventually, as the pulp becomes damaged, consistent discomfort will occur, even when you are not chewing. It is possible that cracks can lead to infection of the pulp tissue, which can spread to the bone and gum surrounding the affected tooth.

Care following trauma:

Injuries to the mouth can cause teeth to be pushed into their bony sockets (intrusion). Your endodontist or general dentist may reposition and stabilize your tooth. Depending on the severity of the injury and stage of root development, root canal treatment is usually started within a couple of weeks of the injury and a temporary medication, such as calcium hydroxide, may be placed inside the root canal system. Eventually, a permanent root canal filling will be used to seal the canal system. If you have had a traumatic injury call our office for an appointment as soon as possible as this injury is very time dependent.

Sometimes a tooth may be pushed partially out of the socket (luxation). Again, your endodontist or general dentist may reposition and stabilize your tooth. If the pulp remains healthy, then no other treatment is necessary. Yet, if the pulp becomes damaged or infected, root canal treatment will be required.

If an injury causes a tooth to be completely knocked out of your mouth, it is important that you are treated immediately. If this happens to you, keep the tooth moist. If possible, reposition the tooth back into the socket. If you cannot replace the tooth, keep it in lowfat milk as a transport medium. Endodontic treatment may be initiated. The length of time the tooth was out of your mouth and the way the tooth was stored, may influence the type of treatment you receive.

About Dr. Marcello

Dr. Marcello was born and raised in Raceland, LA. He graduated from E.D. White High School, then continued his education at Louisiana State University in Baton Rouge earning a Bachelor of Science degree. In 2008, Dr. Marcello graduated from LSU dental school in New Orleans. After graduation, he attended the University of Washington School of Dentistry in Seattle, WA. Dr. Marcello earned his certificate in endodontics and a Masters of Science in Dentistry.


Premier Endodontics
117 St. Michael St.
Thibodaux, LA 70301