Endodontics is the branch of dentistry concerning dental pulp and tissues surrounding the roots of a tooth. It allows you to treat dental elements that would otherwise be condemned to extraction because they are severely damaged. Root canal treatment is an often straightforward procedure to relieve dental pain and save your teeth. A correct root canal treatment is important because improperly devitalized teeth can create problems affecting all the therapies that are performed after devitalization (reconstructions, inlays, prosthetic crowns), leading to the failure of the treatment plan.
In fact, it often happens to have to treat again teeth that have been devitalized not in a proper way, so as to eliminate the chronic residual infection at the apex of the roots, called granuloma. This is an asymptomatic process but easily detectable through an X-ray. In this case we are talking about canal reprocessing. Following the root canal treatment, the tooth will no longer be an infectious reservoir and after an adequate crown reconstruction it will be able to perform the same functions as an intact tooth.
CAUSES OF DENTAL PULP INFLAMMATION
The inflammation or infection of the pulp can occur due to deep caries, a fracture or crack in the tooth but also due to severe trauma. If the pulp undergoes necrosis, the tooth will be asymptomatic not responding to vitality tests, but the pain could shift to the apex of the tooth that will be painful when chewing or touching it with the tongue. Sometimes the affected tooth may appear darker than the other dental elements.
A pulpitis (infection of the dental pulp) not treated in a short time can worsen up to the abscess, often accompanied by a fever. It may happen that there are no obvious clinical signs and that the patient becomes aware of his problem only after a specialist examination thanks to X-rays. In any case it is essential to resort to an endodontic therapy if you want to avoid dental extraction.
ROOT CANAL TRATMENT (DEVITALIZATION)
Endodontic treatment is now fast even for molars, thanks to new techniques and modern equipment. The pain is under control thanks to local anesthesia as today we can also use nitrous oxide.
A muscle soreness, subjectively more or less annoying, is experienced after the treatment, but is easily controlled with a common analgesic.
The operational phases are as follows:
- local anesthesia to neutralize pain even in cases with still sensitive pulp. We remind you that the effect of anesthesia could last even a few hours after the operation;
- temporary reconstruction of the dental crown;
- isolation of the area to be operated by placing a rubber dam (which is essential for the success of root canal treatment);
- opening of the pulsing chamber;
- retrieval of the root canal (s) with the aid of optical enlargements;
- measurement of each channel by X-ray and electronic apex locator;
- removal of the canal pulp;
- washings with sodium hypochlorite, a powerful disinfectant, to obtain an environment that is as clean and aseptic as possible;
- canal filling with gutta-percha, a plastic material that can be molded with heat, associated with a root canal cement;
- crown reconstruction;
- radiographic control;
- possible fixed prosthesis.
During the following two or three days the treated tooth may cause some discomfort, especially in cases of severe infection or inflammation before devitalization. Despite this, the annoyance is totally manageable and controllable even with the use of painkiller.