Medically Reviewed by Dr. Matthew Tomala on July 14, 2026
What most people picture when they hear “root canal” is about thirty years out of date. The tools, the imaging, the instruments used to clean the canal system — all of it has changed. Substantially. It is not marketing language either. Fewer canals get missed. Retreatment rates are lower. Patients who come in now leave with results that were not achievable with the tools from fifteen years ago.
At Burien Endodontics, the technology we use in every case includes CBCT imaging, dental operating microscopes, laser-assisted disinfection, ultrasonic activation, and nickel-titanium rotary instruments. None of this is special-case equipment that comes out for difficult referrals. It is the baseline for how root canal therapy gets done here. For patients preparing for treatment and wanting to understand what to expect step by step, our overview of what happens before, during, and after a root canal covers the full process in plain terms.
How the Equipment Addresses the Actual Failure Points
Most root canal failures trace back to one of a few things. A canal got missed. A crack was not caught before treatment started. The cleaning was not thorough enough and bacteria recolonized the space. That accounts for the majority of retreatment cases we see. The technology did not develop to make the patient experience more comfortable or the office look more impressive — it developed to address those specific failure points.
CBCT maps the canal system before we go in — that is how missed canals get identified before treatment. The microscope finds the hairline crack before we start working. Precision instruments paired with real-time length measurement let us clean to the right depth instead of estimating from a two-dimensional X-ray. For complex cases or retreatments, the difference these tools make is not incremental — it is the difference between a tooth that heals and one that does not.
The Technologies We Use at Burien Endodontics
Cone Beam CT Imaging (CBCT)
Think of the difference between a conventional dental X-ray and a CBCT scan. Flat is what a standard X-ray gives you. It gives you the general shape of the root, but a second canal running parallel to the first in a lower molar will not appear. A crack that only shows up in three dimensions will not appear. The actual spread of infection into surrounding bone often will not appear. CBCT gives you that full picture — all of it, before the procedure starts.
At Burien Endodontics, we use CBCT imaging when the three-dimensional view would change how we approach treatment. In practice, that means most new patients and any case where standard imaging leaves clinical questions open. It lets us accomplish the following before we touch the tooth:
- Identify the full location and extent of any infection
- Map extra canals and branching anatomy that standard X-rays frequently miss
- Detect root fractures and resorption before treatment planning
- Assess whether a tooth is realistically restorable
- Plan the most precise approach for that specific root system
That detail makes a difference mid-procedure. You do not find out there was a fourth canal once you are already cleaning the other three.
Dental Operating Microscopes
We run the microscope on every case here — it is not something we bring out for the complicated ones. At magnifications between 8x and 25x, it is how we find the fourth canal on a molar that imaging showed as three. It is how we spot a hairline crack before we start cleaning. It is also how we know the tissue removal is actually complete, not just approximately complete.
We use the microscope on every procedure at Burien Endodontics — not just the cases that look difficult going in. Sometimes the cases that look routine on the scan are not. We would rather find that out at 20x than halfway through a cleaning. Every study that has looked at this shows the same thing: lower retreatment rates when the procedure is done under magnification. Using it on every case is an obvious call.
Precision Cleaning Instruments
The files used to clean root canals used to be made of stainless steel — rigid, prone to breaking in curved root anatomy, and not well-suited to following the natural shape of a canal. Nickel-titanium (NiTi) rotary files are different. They are flexible. They bend. They follow the canal’s natural curve without fighting it. Stainless steel instruments were rigid and broke in curved canals — NiTi files do not. There is a study in the National Library of Medicine on this: curved canal procedural errors are significantly lower with NiTi rotary instruments than with manual stainless-steel filing.
Add in an electronic apex locator — which measures the canal length in real time instead of estimating it from a two-dimensional X-ray — and you get cleaning to the correct depth, every time. What that gets you: cleaner canals and a better long-term seal.
Laser-Enhanced Disinfection
Standard irrigation gets the job done in most cases. Laser disinfection gets to where irrigation does not. Laser energy gets into the dentinal tubules in the canal walls — the tiny channels inside the dentin where bacteria can persist after standard flushing. Plain irrigation does not get in there reliably. For patients who want to understand more about how lasers fit into endodontic treatment, our post on the role of laser technology in endodontics goes deeper. We use it at Burien Endodontics as a complement to standard irrigation, not a replacement — and particularly on retreatment cases, where the original procedure may have left contamination in hard-to-reach areas.
There is also a reduction in inflammatory response in the tissue around the root tip — which tends to show up as less discomfort in the first day or two after treatment.
Ultrasonic Activation
Ultrasonic activation is something that does not get explained much to patients, but it matters. When you activate the ultrasonic tip, the irrigation fluid starts streaming — agitation that breaks up debris, disrupts biofilm, and drives the solution into the side branches and irregular pockets of the root system that ordinary flushing misses entirely. Molars with complex anatomy get the most out of it, but it is part of our standard process regardless.
Biocompatible Sealing Materials
Cleaning the canal is one half of the procedure. Sealing it properly is the other half, and that part does not get as much attention. Thermoplastic gutta-percha flows under heat to conform to every contour of the canal and resists bacterial reentry over time. Bioceramic sealers, now used alongside gutta-percha in many endodontic offices, work differently from the old paste-based materials. Once they cure, they are bonded to the canal wall. They also release calcium hydroxide as they set — a compound that actively supports healing in the periapical tissue. It is not just filler; it is doing something. These replaced older sealers that could shrink or degrade over years, which was one of the more common long-term failure mechanisms in older root canal treatment.
What This Means for Your Appointment
What it amounts to, in practical terms: you arrive at your procedure with accurate information about what is actually in there. The treatment plan is already calibrated to your root anatomy before the first instrument goes in. The instruments follow the canal system instead of working against it. The disinfection reaches further. The seal at the end is more durable. What we hear from patients afterward, pretty consistently: the procedure was not what they expected. At all. The equipment is most of why.
Coming to an endodontic practice also means coming to a place where this is the everyday standard — not equipment pulled out for the hard referrals. We use the CBCT, the microscope, the laser as part of normal daily practice — not as tools we reserve for the hard cases. Every case.
Frequently Asked Questions About Advanced Endodontic Technology
What is the success rate of a root canal with advanced technology?
Very high for teeth that get a crown placed in a reasonable timeframe. We see teeth treated with CBCT guidance and under the microscope that are holding up well years later. The things that used to go wrong — a missed canal, incomplete cleaning — are harder to miss when you have CBCT and a microscope. What your outcome looks like depends on the tooth’s anatomy, how far the infection had spread before treatment, and whether you follow through on the crown. We will tell you honestly if a tooth looks like a poor candidate before we start.
How does a dental operating microscope improve my root canal?
Things become visible that are not visible any other way. Like a secondary canal opening on a molar. Or the difference between complete tissue removal and 95% complete — without magnification those look identical. Every study that has looked at this shows the same thing: lower retreatment rates when the procedure is done under magnification. We use the microscope as standard on every procedure at Burien Endodontics, not just the ones that look complicated in the imaging.
Is CBCT imaging safe for patients?
Yes. Dental CBCT systems deliver a low radiation dose — comparable to a standard series of periapical X-rays for a focused single-tooth scan. At Burien Endodontics we use CBCT when the three-dimensional view would actually affect treatment planning — not as a default addition to every visit. The benefit-to-dose ratio is well-established in the endodontic literature.
How long does a root canal take with modern technology?
Most cases at Burien Endodontics finish in one appointment of 60 to 90 minutes. NiTi files and real-time apex measurement both cut time compared to older manual approaches. A molar with four canals takes longer. A retreatment — going back into a previously treated tooth that did not fully heal — sometimes needs two visits. After reviewing your CBCT imaging, we will give you a realistic estimate before your appointment.
How do I know if my endodontist uses advanced technology?
Ask directly. Does the practice use CBCT for diagnosis? Does the endodontist use a dental operating microscope? Do they use NiTi rotary instruments? At Burien Endodontics, the answer to all three is yes. We are happy to walk you through our approach and equipment at a consultation — there is no reason that should feel like a mystery before you commit to treatment.
Dr. Matthew Tomala and the team at Burien Endodontics treat patients across Burien, SeaTac, and South King County who have been referred for root canal treatment or who are dealing with tooth pain that has not been clearly diagnosed. We use CBCT, operating microscopes, and laser disinfection as standard for every case. If you have a referral from your general dentist, or if you are looking for a second opinion on a tooth that has been bothering you, we are ready to take a thorough look.
To schedule an appointment, fill out our contact form and our team will follow up promptly.
About the Author
Dr. Matthew Tomala is the provider at Burien Endodontics, where his practice is focused entirely on endodontic treatment — root canal therapy, retreatment, and dental trauma assessment. He uses CBCT imaging, dental operating microscopes, and laser-assisted disinfection for patients across Burien, SeaTac, and greater South King County. Read full bio