MODERN ENDODONTICS, ROOT CANAL TREATMENT WITH MICROSCOPE
Everything you should know about root canal treatment
Endodontology is a branch of science that deals with the anatomy, function and health of the pulp (tooth pulp) or of the periapical tissue (surrounding the tip of the root). In practice, this goes beyond the well-known root canal treatment for the prevention of tooth pulp diseases, for the therapy of the still vital tooth and for the treatment of previously unsuccessful root-treated teeth. All of these treatments serve to preserve the tooth in some cases where the other alternative would only be the extraction of the tooth. Of course, we always strive to give preference to the least invasive, i.e. the least intrusive treatments in all areas of dentistry, as maintaining the original structures has many advantages and the therapeutic possibilities are considerably expanded. If for some reason tooth preservation is really not possible, the final step is to remove the tooth and, if possible, replace it with an implant or other prosthetic solution.
The biological value of natural teeth is priceless, both aesthetically and functionally, and there is a growing need for both patients and professionals to preserve them. We should not forget that an untreated or inadequately treated "diseased" tooth can not only cause local problems, such as pain, inflammation of the tissue around the apex in the jaw, but also has a number of unfavorable effects on the general health of the individual. (Focus of disease). This makes it clear why properly and precisely performed endodontic procedures are important in order to prevent and heal the above-mentioned damage or to guarantee the symptom-free, even lifelong preservation of the tooth.
Endodontics then and now
The advancement of science and the changed dental, so-called minimally invasive view enabled or required the development of new protocols. Prior to the appearance of technological advances, we followed a series of rules developed decades ago and dictated by the possibilities of that time, including poor lighting ("blind" root canal), tactile perception, and the use of rigid, inflexible tools. So we can imagine what a major breakthrough meant the invention and development of the surgical microscope and other technical achievements (e.g. modern imaging techniques, machine root canal treatment devices, electrical length measuring devices, flexible tools) in endodontics, which allowed access beyond visual control of the narrowest canals, even those with complicated anatomy, made possible in a way that was impossible before. The key to long-term success is precisely how well we can clean and decontaminate the canal system of a particular tooth. We can only treat what we see and achieve, so we can minimize the risk of re-infection of any remaining tissue or bacteria and thus prevent unwanted tooth extraction.
In our clinic, the treatments are fulfilled using the most modern methods; with the aid of a surgical microscope and using the latest technologies, best tools and materials available on the market, performed by a root canal specialist according to well-documented and clinically proven protocols. The costs of the treatment are calculated on the special tools, expertise and time spent, which are usually even less than the total costs of other ultramodern denture solutions, not to mention the inestimable biological value of the natural tooth.
What actually is the root canal treatment?
During root canal treatment, after anesthesia, the tooth cavity is exposed, its contents are removed, the remaining space (pulp chamber and root canals) is prepared and disinfected, and the entire length is closed.
After completing the root canal treatment, the tooth is constructed, i.e. the correct restoration is selected and carried out (filling / inlay / crown), which in many cases also requires post and core. However, this restoration no longer means endodontic treatment.
When can root canal treatment be necessary?
- deep caries in the tooth
- tooth rhexis, tooth fracture
- dental trauma
- iatrogenic causes - possible undesirable consequences of dental treatment (e.g. preparation, orthodontic treatment)
- in order to be able to anchor a post, if we do not have enough intact tooth material for the reconstruction, it has to be replaced
In most cases, it is an irreversible inflammatory process of the tooth, which invariably leads to the death of the tooth.
In the background, there are various causes, most of which cause the infection of the dental pulp and lead to inflammation, such as in the case of deep caries. In other cases, the pulp itself may be intact, but due to certain effects on the tooth, what is known as "sterile inflammation" or even immediate pulp necrosis occurs. The result is the same in all cases, the tooth dies, so that a root canal treatment becomes essential.
Root canal treatment step by step (1 or 2 steps are required)
- After the examination, an X-ray and / or a CT scan is made and an accurate diagnosis is prepared.
- We anesthetize the tooth, so the treatment is completely painless.
- The tooth is isolated by placing the dental dam in order to keep it clean and to protect it from bacteria in the saliva.
- After the carious parts have been completely removed, the tooth chamber is opened, the root canals are searched for and the patency is checked.
- The length of the canals is measured using an electrical measuring device so that they can be completely cleaned.
- The root canals are prepared chemically and mechanically using special tools, mechanical instruments and various rinsing fluids of different compositions and afterwards dried.
- If the canals can be completely dried out and the situation does not contraindicate treatment in one step, the canals can be permanently closed by introducing a biocompatible root sealant.
- However, if the canals cannot be dried out or if the tooth is heavily infected and / or inflamed, we temporarily seal it with a special paste to dry and further disinfect the canals, and the next time after repeated cleaning and drying, the final root filling is inserted.
- This is followed by the prosthetic restoration of the tooth, i.e. its reconstruction.
Advantages of microscopic root canal treatment:
- the excellent extension and direct lighting allow a complete visual control of our work and allow us to carry out treatments with a much better quality and precision than with conventional techniques
- helps to prepare an exact diagnosis - e.g. discover / exclude rhexis, which is the reason for the unsuccessfulness of many root canal treatments
- the treatment is much safer and there is a great chance that the tooth will be saved
- minimal loss of tooth material
- canals can be discovered that are not visible to the naked eye - e.g. in most cases the upper 6th teeth have a fourth so-called additional canal (MB2), which is usually impossible to discover and prepare with the naked eye
- root canals with complex anatomy can be opened and cleaned
- no untreated, inflamed parts remain
- the risk of complications is significantly lower
- successful, complete removal of old, no longer functioning root fillings
- the possibility of closing open root apex
- supply of wrong ways (via falsa) and perforations (unwanted breakthrough)
- the possibility of removing broken instruments
- the patient can follow the treatment on a monitor that is attached to the dentist’s chair