Root canal treatment
Endodontology - root canal treatment
Root canal treatment, also called endodontic treatment, is a dental treatment which removes the pulp from the root of a tooth, filling up the resulting space. The hole that the dentist has had to make to get to the root is then filled.
Indications for root canal treatment are:
- pulpitis or toothache: caused by caries, deep fillings, injury
- nerve death through caries, deep fillings, injury
- periapical abscess
- preparation for prosthetic treatment (crowns, veneers etc.)
- aftercare for reimplantations
What is a root canal treatment
The main aim of root canal treatment is to disinfect and hermetically seal both the root canal and pulp chamber. Multiple preparation techniques, filling techniques and materials are possible. It is very important to use a disinfectant during treatment. The most commonly used disinfectants are sodium hypochlorite, chlorhexidine and EDTA. These kill the highest amounts of bacteria in the canal. If these do not do the job, there is a higher chance of developing a periapical abscess later on. Disinfectants much reach the entire root, and therefore the channels are widened (or prepared). This happens either mechanically or manually with extra fine files. After the channels are completely disinfected, down to the very bottom of the root, these channels must be filled. Gutta percha in combination with special cement is most commonly used as a filling material. MTA is a relatively new product used for a limited number of situations. There are various techniques used when filling up the channels, including the use of both cold and heated gutta percha. What is essential in every one of these techniques is the condensation (pressing) of the gutta percha. This pressure is crucial for the forming of a good hermetic seal so that the bacteria can not penetrate into the channels again. If the channels are correctly prepared, disinfected and filled, one must also fill the tooth correctly. This can be done with a filling or a crown. Closure is very important in order to avoid reinfection.
To improve filling fixation, we sometimes add one or more pins into one of the filled channels. This means a portion of the gutta percha will be removed to make room for, for example, a (fibreglass) pin. This provides additional support for the new filling.
Often, your dentist will recommend that you get a crown at a later stage. This is because root canal treatment often means a lot of dental tissue is removed. This increases the chance of breakage. A break could eventually result in loss of the tooth.