Root canal treatment
Root canal treatment
What is a dental pulp?
Dental pulp is the internal part of the tooth that is covered with dentine. Blood vessels, nerves and immune cells can be found here. Pulp provides nutritive and protecting functions, it’s capable of launching dentine production and if it’s exposed to stimuli, the pulp will respond with protective reaction. Dental pulp is made up of pulp chamber and root canals. Depending on which tooth we’re talking about, there may be one or even four root canals.
When is it necessary to make a root canal treatment?
Root canal treatment is one of the tooth preserving treatments. It might be needed for several reasons, one of them is pulpitis (the inflammation of the dental pulp). If cavity has got so far that it reaches the pulp and the latter is not able to produce any protecting dentine layers anymore, pulpits is established - in certain cases, it’s accompanied by intense pain. Usually, this is the most common cause of visiting the dentist. In the beginning, our tooth is more sensitive to cold, hot and sweet food but as the process advances, intense pain, so-called pulpits attacks evolve. These attacks are more intense at night, when you’re in recumbent position since blood circulation is different that way. At the early stage - if decayed parts can be entirely removed and the pulp isn’t damaged at more than one point during drilling, we might try the pulp capping technique. During this treatment, we place calcium and fluoride- containing material on the damaged pulp and fill the tooth. If pulpitis is irreversible, we need to make the root canal treatment. This treatment is as much necessary when it comes to deep caries - in such a case, the major part of the pulp is damaged after the complete removal of decayed areas.
Root canal treatment might be necessary if the tooth suffers a mechanical damage that causes its destruction or when the tooth crown is fractured to an extent that it can only be rebuilt after this treatment. Our teeth might die without any symptoms - in such cases, x-rays and clinical trials may reveal the actual condition. At this stage - despite the fact that there’s no pain - root canal treatment must be performed since a dead tooth maintains a continuous, chronic inflammation in the body. Furthermore, bacteria get across the roots to the tissues around the tooth and this might cause inflammation. In a lot of cases, it’s accompanied by pain, percussion or bite sensitivity might emerge and if it’s more serious, swelling may occur as well. These inflamed teeth might also cause nodular diseases.
How do we perform root canal treatment?
Contrary to old beliefs, root canal treatment can be carried out without any pain.
As the first step of root canal treatment, we remove the infected parts of the tooth and we shape a hole that allows access to root canals. The dental pulp is entirely removed. Besides mechanical processing, chemical disinfection is done as well during root canal treatment. Our dentists are experienced users of the latest canal root machining tools as well as hand-dissecting tools. During chemical disinfection, we eliminate bacteria and remove tissue debris from the root canals using various leaching liquids. While performing root canal treatment, we define the working length with the help of an electronic device, an apex locator. By working length, we mean the root canal’s entire length since our aim is to remove the infected tissues from the full channel section and make a root canal shape that is suitable for root filling. A good, hard-wearing root filling prevents the root canal from recontamination. It blocks the way from bacteria at the root’s peak, sidewall and crown area. After having the root canals shaped to the appropriate form, our dentists do the root filling using the latest materials.
Complications
Unfortunately despite the dentist’s most precise work, complications might emerge during root canal treatment. This mainly follows from the complicated anatomy of root canal systems. If the canals are curved or narrow, the endodontic instruments might be broken, the root canals might have side canals that need multiple and circuitous treatments to be cleaned. Because of these, dental problems might emerge between the treatments, such as pain or swelling. Unfortunately, it’s also possible that the tooth must be extracted. For reassurance: thanks to modern dentistry, such cases are less frequent.
After root canal filling
It’s necessary to discuss the final maintenance of root canal treated teeth. In a lot of cases, the tooth can’t be restored with a simple filling since this process requires significant sacrifice of the bone material. In such a case, we make an inlay or an implant supported crown. These restorations ensure more protection for tooth fracture and with their help, we can achieve a completely anatomic shape.