Endodontic treatment of teeth is a common method of therapy that aims to eliminate diseases of the pulp. The pulp is a soft tissue inside the tooth. Dental endodontics primarily involves working with root canals and tissues adjacent to them. As a rule, this method is used for inflammation of the pulp, which is otherwise called pulpitis. At the same time, the canals in the root part of the tooth are cleaned, the pulp is removed and the pathogenic microflora is cleansed, which often accumulates there.
What is pulp and pulpitis?
The pulp is the inner part of the crown of the tooth, which is represented by soft tissue. The pulp is often referred to as a nerve, however, it contains not only nerve endings, but also blood vessels, arteries, veins, lymphatic vessels, and even connective tissue. Pulpitis is an inflammation of the pulp. This disease is one of the most common in dentistry. Most often, pulpitis occurs due to microbes and toxic substances entering the pulp.
In some cases, inflammation inside the tooth begins due to trauma, which leads to a cessation of blood flow to the pulp tissues. Since this area does not receive the necessary nutrients, over time, necrosis of cells and tissues inside the tooth occurs, and pulp necrosis occurs.
The main symptom of pulpitis is acute pain in the tooth, which occurs spontaneously. If the pain appears when eating hot food, we can talk about tissue necrosis. In the case of pulpitis, pain is most often manifested at night.
Main tasks of endodontics
Endodontic root canal treatment is required in cases where the patient has already developed teeth with inflammatory changes around. In addition, endodontics is prescribed immediately when the patient has an irreversible inflammatory process in the pulp that cannot be treated. Also, the pulp is removed completely if it is no longer recoverable.
In the treatment of pulpitis using the method of endodontics, the doctor faces several main tasks:
- Eliminate the symptoms of inflammation, namely, pain in the tooth.
- Destruction of the focus of inflammation.
- Acceleration of the healing process and complete recovery of the tooth.
- Restoration of the original shape of the tooth and its functionality.
- Prevention of the development of periodontitis.
In rare cases, when the dentist performs the installation of crowns or bridges, endodontic treatment is required first so that later the pulp is not damaged and complications do not arise. In addition, this procedure is also sometimes performed before gum treatment.
Types of endodontics
First of all, endodontic dental treatment is carried out in order to preserve the health of the tooth and not remove it completely. If, in the presence of an inflammatory process in the pulp, endodontic treatment was carried out incorrectly, or was absent altogether, in most such cases the tooth is removed.
Endodontic treatment is divided into primary and repeated:
- Primary treatment occurs when the patient first has inflammation in the root canals and pulp. In such cases, the roots of the tooth have never been treated before.
- Repeated endodontic treatment is carried out already as a measure to correct the unsuccessful result of the first therapy session.
Stages of endodontic treatment
Before prescribing endodontic treatment, the doctor performs a complete examination of the tooth in order to determine the source of the disease and understand all the features of the inflammatory process. In addition, after receiving the results of X-ray or computed tomography, a plan is made for procedures to remove the pulp and clean the root canals. Immediately before endodontics, the patient must be anesthetized.
The method of endodontic treatment itself includes the sequential execution of several stages:
- Opening of the cavity of the tooth. This measure is necessary in order to ensure normal access to the root canals. The cavity of the tooth is prepared so that it can be penetrated into it with special tools. Next, the contents are removed, which includes the pulp itself, the infected part of the bone substance, as well as the accumulated microorganisms. In addition, at this stage, the walls of the channels are also cleaned of microorganisms and dead tissues using special, very thin instruments.
- Next, the doctor determines the length of the root canals and prepares them for filling. At this stage, the canal is treated with an antiseptic.
- Canal disinfection in most cases is carried out for a long time. The doctor lays a special substance that creates a highly alkaline environment in the canal and leaves it for two weeks. Treatment continues after this time at the return visit to the doctor.
- After the inflammation is removed, and all pathogenic microorganisms are destroyed, the doctor proceeds directly to filling. Today, there are many options for installing seals and many materials used for this purpose. The 3D obturation method is considered the most effective. In this case, gutta-percha is used as a material, which is a natural material with an elastic structure. Such material is used with a special glue - sealer.
Sometimes patients require restoration of teeth after endodontic treatment. Mostly this happens when there are any complications. If a small amount of tissue was removed during endodontics, then a conservative method using flexible ceramics is suitable. If the tissue loss was severe, it is recommended to install the pin inside the tooth. This will securely fix the filling substance on the rod, which is inserted deep into the root canals.
