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Endodontic therapy is a set of measures to preserve the function of teeth and their aesthetic appearance. Therapy methods according to a unified protocol allow cleaning and resealing of canals, sealing, and prevent complications.
What is pulpitis?
The cause of the problem: microorganisms of the carious focus. They penetrate into the pulp, stimulate inflammation of soft tissues, irritate the vascular-nerve bundle, causing severe pain. The pulp ceases to perform its tasks and becomes an environment for the development of bacteria, which in the long run leads to its death. If you do not immediately consult a doctor, pulpitis turns into periodontitis and affects the surrounding tissues. This leads to abscesses and tooth loss. The problem is solved by treatment with pulp removal, cleaning of the root canals of the teeth, filling of the canals.
Dental treatment under a microscope
The structure of root canals is unique and has its own peculiarities. The anatomy of the upper canines, front and lateral incisors on both jaws is different. Two-channel structure, narrowing in the mouth near the enamel-cement border, other features complicate the treatment.
Diagnostics using high-precision equipment significantly increases the success of therapy. The dentist begins the examination with the usual examination, tests, probing, intraoral imaging and sometimes computer tomography. A detailed 3D image allows you to see the details of the tooth's anatomy, the problem from the inside, and assess the state of the bone tissue.
Based on these data, the doctor plans treatment with the use of an optical microscope, which increases the working field twenty times. Illumination repeatedly improves visibility even in narrow channels. The device highlights all problems, including perforations and cracks of the root, remnants of necrotic tissue.
Stages of treatment
Before the treatment, the tooth is anesthetized and isolated with the help of a rubber dam, which is a mandatory condition for root canal treatment. The doctor prepares the tooth, removing the damaged tissues and forms access to the pulp chamber in such a way as to preserve, as far as possible, healthy, unchanged tissues. If necessary, part of the tooth is restored to form a convenient, safe access.
Channel processing
Treatment of canals consists of their mechanical and medicinal treatment. With mechanical processing, complete patency of the channels is achieved, if possible, by giving them a conical shape and sufficient width for washing. Medicinal treatment allows you to dissolve the dentin sawdust that has formed and to disinfect the cleaned canal walls.
In complex cases, when the infectious process has gone beyond the tooth and caused inflammation of the periodontium, in which pus or other exudate flows from it into the tooth, and at the same time the tooth cannot be "dried", medicine can be introduced into the canals for one or several days.
Filling
After cleaning and preparing the canals, the dentist proceeds to cutting, that is, filling the canals using volume filling with biocompatible materials (sealer and heated gutta-percha).
Aesthetic restorations
Endodontic treatment will be successful only after the full cycle has been completed. Despite the thorough cleaning of the canal, there is a risk of re-infection without a hermetic restoration.
Next comes the recovery stage. During root canal treatment, part of the tissue is lost due to caries and preparation or due to chipping, and the crown needs to restore the lost volume and aesthetics. For restoration, the dentist offers the patient:
- sealing with composite materials;
- recovery;
- installation of crowns and crowns.
For direct modeling in the mouth, the dentist uses a photopolymer composite. A layer-by-layer restoration, cured with a special lamp, takes on the appearance of a healthy tooth. Thanks to polymerization, a strong connection between the layers is formed.
In some cases of significant tooth destruction, the restoration is strengthened with a special pin installed inside the root.
Indirect restorations in the form of inlays and veneers are made by a dental technician from ceramics based on casts.
The labor-intensive process requires a highly qualified doctor, high-quality materials, and technological equipment. Therefore, therapy, especially canal resealing, is considered an expensive procedure. The doctor determines the exact cost later
