Endodontics is concerned with the interior (endo) of the teeth (dontia). The dental pulp is the tissue at the teeth core featuring nerves, blood vessels and tissue specific cells. Its aim is to produce healthy tooth and to sense external stimuli.
Decayed, fissured or fractured teeth enable bacteria to reach the pulp causing its necrosis, which could be followed with pain and edema associated with an abscess. However, sometimes there are no signs. The conservative procedure to treat these teeth is endodontics, since the alternative would be to the extraction of the tooth.
The root canal treatment removes the total content of the radicular canals, followed by the decontamination and filling of the canals. The goal is to encourage a favourable environment, which allows the proper healing to the surrounding tissues keeping them functional and symptoms-free.
The success rate of this treatment is very high (96% when performed adequately). However, it’s still no guarantee of success, which is dependent upon the healing response of the patient.
Endodontics is also the treatment of choice for constant increased sensitivity to hot and cold, to pressure and during chewing, and to darkened teeth. After the endodontic treatment it is possible to bleach these teeth allowing you to smile broadly with confidence.
Redoing the endodontic treatment should always be the first therapeutic option to save the tooth previously submitted to root canal treatment. During this procedure, the content of the root canals is removed to acquire a new disinfection and shaping of the area and afterwards to achieve a new sealing. Thus, in most cases, it is possible to correct the initial cause of failure and creating the conditions to restore the tooth health.
Apical micro-surgery is the treatment of option when the endodontic treatment does not solve the infection on its own and the most apical portion of the root is removed.
Tecnology and Endodontics
The continuous research has led to a remarkable development resulting in new techniques, devices and materials.
We highlight the following:
- Digital xrays: with only 1/8 of the radiation dose of a traditional xray
- Mechanical instrumentation: The use of highly flexible nickel titanium files adapted to rotating devices enable a more predictable shaping of the root canals.
- Apical foramen locators: allow to determine electronically where the root canal being treated ends.
- Ultrasound: Enables a proper anatomical shaping, cleaning and removal of mechanical impediments from the root canals. These devices revolutionised even the ability to create cavities at the root tips whilst performing a safer and reliable root canal surgery.
- Dental Microscope: Enlarges the operating site, essential in such a small area as the pulp and also provides an intense homogenous co-axial lighting which allows the clinician to visualise features not otherwise perceptible to the naked eye or even with lupes. Therefore, the dental microscope increases precision and the quality of care and expands the range of treatments available.