ROOT CANAL TREATMENT
When tooth decay reaches the tooth nerve, it inflammes and has to be removed.
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Bacteria in the dead nerve slowly penetrate through the opening at the tip of the root into the surrounding bone, where they cause inflammation. The bone around the tip of the root resorbs due to inflammation and the body replaces it with inflammatory granulation tissue as a defense against bacteria. Over time, this "limited" inflammation ("granuloma") increases with proportionate bone loss and thus represents a chronic bacterial focus, which also affects other organ systems in the body .
Three factors are important for the success of endodontic treatment
1. Detecting the shape of the root canal system
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Each tooth has its own peculiarities. We use digital three-dimensional imaging (CBCT) that accurately displays the anatomy of the canals in the root. This is very useful for re-treating teeth because it is crutial to find out why was the previous treatment unsuccessful. We can notice un obstruction of a root canal due to calcification, or a strong curvature of a canal which is difficult to clean. There may have been left a broken needle inside of the canal from the previous treatment or the canal may be treated insufficiently or in the wrong direction, significantly complicating the work on re-treatment. All this determines the difficulty of the procedure and gives us an orientation about the probability of success.
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2. Complete root canal cleansing
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The goal of endodontic treatment is to remove all dead and inflamed pulp tissue and bacteria from the root canals, since a 1 mm uncleaned root canal may contain enough bacteria to keep the inflammation present and treatment unsuccessful.
Mechanical shaping of the canals is performed using special endofiles that are made of nickel-titanium alloy and are sufficiently elastic and resistant to adapt to the shape of the root canal.
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3. Disinfection and obturation of the root canals
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Desinfection is done with a disinfection solution, which is applied to the root canal and activated with utrasonic vibrations that help the fluid reaches all the hidden places in the canal system and disinfects more efficiently . Thermoplastic obturation is used for filling the canals, where gutta-percha pins are softened by heat, and thus a compact filling is achieved.
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Teeth with a root canal treatment are more fragile and often require placing of a crown .
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In rare cases, endodontic treatment has to be completed with an apicotomy.
An apicotomy is the surgical removal of the apex of the root followed by the process of refilling the root canal. Using a 3D dental image (CB CT) we plan the procedure, which is then performed under local anesthesia.