Endodontics – root-canal treatment

Thanks to the dramatic advances made in dentistry in the last few years and the growing awareness of this fact among patients, who would prefer to keep their own teeth rather than have them removed and replaced with prosthetic substitutes, endodontics (root canal treatment) has become a very important feature of everyday dental practice.

In the past very damaged, painful teeth would have had to be extracted - today the situation has changed dramatically – the chances of saving and reconstructing such teeth are very high and more and more rarely is the decision made to extract them . Root canal treatment involves the precise removal and cleaning of a root canal from inflamed, dead or gangrenous tooth pulp (the “nerve” pulp is a neurovascular bundle which reacts to stimuli and nourishes the tooth), and later sealing it tightly, i.e. closing up the canal with a biologically neutral material. Nowadays such treatment can be carried out using a local anesthetic in one visit.

The most frequent cause of dental pulp inflammation is untreated caries and bacteria causing the tooth decay. Sometimes, in cases of advanced paradontosis, this can lead to bacterial infection of the root apex, i.e. so-called endo-perio lesions. Past traumas may also necessitate root canal treatment. Endodontic research carried out in recent years irrefutably shows that eliminating bacteria and their toxins from a root canal and ensuring that the canal system is properly sealed through obturation guarantees successful treatment, as is also the case with earlier emerging periapical lesions. Thanks to advances in endodontics these procedures can be carried out today carefully and accurately. Use of a microscope ensures us better control over the treatment process, and with the help of an apex locator, i.e. a device for locating the apical foramen, we can determine the length of the canal that requires treatment. Increasingly popular and effective rotating nickel-titanium tools allow us to work on not-patent and curved root canals with greater accuracy. Mechanical treatment is aided by intensive irrigation using such agents as sodium hypochlorite, hydrogen peroxide and other agents. In certain cases additional sterilisation of the root canal with ozone is recommended. The final stage of the work involves filling and building-up of the tooth canal. The root canal should be filled so that it’s lumen is completely sealed along its entire length, thereby ensuring that no bacteria or physiological fluids can penetrate. For the last few years a gutta-percha has been used for this purpose. It meets all the requirements: it is non-dissolvable, neutral to periapical tissues, and, plastic under the influence of temperature, flows to and adheres tightly to the irregular surface of a tooth canal. In recent years gutta-percha has encountered competition from a new resin-based material – resin-percha - which ensures more air-tight adherence.

In addition, we also make an RVG image of the root canal during a visit, which provides us with one final opportunity to check whether the canal has been filled properly. The radiovisiographic system provides us with an immediate reading, and also minimises doses of X-ray radiation. The treated tooth can be of service for many years and serves as a natural base for any later reconstruction of a tooth crown. It can also be used to anchor a prosthetic device. Endodontic procedures are both time-consuming and labour-intensive, but when performed properly guarantee a long-lasting tooth and thus ensure greater comfort in our lives.

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