Root canal treatment is a treatment of the interior of the tooth, namely the zone occupied by the pulp – nerve tissue of the tooth. In the parlance of the tooth pulp is called “nerve”. The pulp consists of blood, lymph vessels, nerves, and loose connective tissue.
What is a root canal?
Anatomically, the tooth consists of crown and root. Crown is the part that is above the gum, and the root is in the thickness of the jaw bone. Neurovascular bundle enters the tooth at the very top of its root or roots. From the entry point of the nerve to the pulp chamber (cavity, which is in the center of the tooth), the entire length of the tooth, are narrow channels – this is the root canal of a tooth.
Why should you treat the root canals?
Pulp (nerve), as any other body, reacts on an irritation by an inflammatory response.
The main cause of inflammation of the nervous tissue of the tooth is carious lesion. With the progression of the caries process and the destruction of the enamel, the bacteria penetrate the dentin. Deep carious lesions reaching the dentin, enables bacteria to penetrate into the pulp of the tooth and cause an inflammation of the pulp. Getting inside the tooth, the bacteria begin to actively proliferate. It violates the normal functioning of the tooth and causes the discomfort or pain to a person. The organism itself can not solve the problem because the bacteria destroy not only the tooth, but also destroy the system to protect it: blood vessels are no longer able to deliver to the lesion special defense cells, able to fight infection. We should get rid of such a nerve.
Purpose of root canal treatment
Endodontic therapy. This therapy is alike to the cleaning of the root canal (the part that originally occupied the nerve tissue). Cleaning the root canal is done in order to eliminate bacteria. While achieving three goals:
1. Elimination of bacteria that had accumulated inside the tooth;
2. Tissue of the nerve is removed and all other organic wastes the fertile ground for bacteria;
3. Space of the tooth nerve is filled and sealed, so that the bacteria have no place for existence;
What teeth do need endodontic therapy?
In order to determine the need of the endodontic treatment (root canal treatment) dentist thoroughly examines your teeth. Based on the clinical and radiological survey data, a doctor decides if an endodontic therapy is necessary.
There are many situations when root canal treatments are alternative.
The main indications of the root canal treatment are the following situations.
– Inflammation of the dental pulp. Inflammation in dental pulp is called pulpitis. The main symptoms of pulpitis are repeated sore tooth, nocturnal spontaneous pain;
– The doctor begins to treat tooth decay and in the course of treatment reveals that the tooth is damaged how deep, nerve tissue infected.
– The presence of sensitivity, swelling, discoloration of the gums around the tooth;
– Necrosis (necrosis) of the tissues of the tooth pulp. Pulp necrosis symptoms. On such a situation, the patient does not know that tooth was ill; there were no changes near the gum. Because of this, a patient can not notice the ill for years. Although such teeth can be detected by X-rays. In the most obvious cases, X-rays reveales a dark spot at the tip of the tooth root. This dark spot indicates that around the apex a cavity is emerged from inside of the tooth infection;
– There is periodical or continuous emerging on the gums.
Sometimes on the gums near the teeth the emerging resembling the form of acne appears. In dentistry, these formations are called the sinus passages. These structures themselves can come and go, and change in size. This condition is often found near the tooth, with deadened the nerve, the disease is asymptomatic.
– Teeth are damaged in the accident. State of the pulp of teeth, damaged in an accident (injury, car accident, etc.) may decrease and there is a need in the treatment of root canals. However, such conditions are often asymptomatic, and again we have the support of X-ray. Such an asymptomatic condition can last for years. If the tooth is getting dark – this is one of the signs that there are destructive processes (necrosis of the dental pulp).
Therefore, the earlier root canal treatment starts; there will be the greater opportunity in the future to get rid of the unpleasant complications.
Stages of endodontic therapy
Endodontic therapy consists of the following stages: pain management, isolation of the tooth from the oral fluid, providing access to the area of the pulp, the root canal cleaning, and root canal filling.
Tooth pain relief
Root canal treatment procedure was considered as a very painful. But this is absolutely not true, because in modern dentistry there is the concept of “treatment without pain,” which is quite justified. Root canal treatment is a procedure completely painless, no different from tooth fillings.
The pain relief is made before the beginning of root canal treatment. During anesthesia the patient doesn’t feel the discomfort associated with the injection, and the spread of anesthetic solution (anesthetic), in place of the needle anesthetic gel smeared high concentration. And the penetration of the needle in the lining of the patient never feels the process of anesthesia.
Provide access to the root canal
Before cleaning the root canal, the dentist must provide good access to the root canals. To get good access to the area of the dental pulp cavity of boron is made, leading to root canals. Young patients get larger access, because they have a large pulp chamber. And the teeth of elderly patients have a lower cavity of the tooth, so it requires less preparation.
Access to the front teeth is on their back side, on the back teeth, on the chewing surface.
Preparation for cleaning of root canals
Cleaning the root canal includes mechanical and pharmacological treatment (we know that root canals accumulate a lot of bacteria.) At the stage of root canal treatment it is important to remove the bacteria, the pulp tissue, which can be of necrotic (dead) and infected.
Mechanical treatment of root canals is done with the help of a special tool called a file.
These tools are very similar to straight needles; they have a certain length, size, taper, surface, resembling a saw. The dentist treats a set of root canal files, performing up and down movement of the tooth through the channels at the same time making their rotational movement.
Dentist carries the medication of disinfection by irrigation of canals by special disposable needles.
Processing files over the entire length of the root canal to the very top of the root, and not on top. The main stage in the treatment of root canals is to determine the length. To do this, the dentist first inserts into the channels files and makes X-ray, which is determined by the length of the root canal.
After thorough cleaning, root canal, the dentist can begin canal filling. Sometimes there are cases where it is recommended to wait for a week before the final sealing of the root canals. In this case, the dentist places the temporary filling to this week to prevent an infection.
Root canal filling
The success of the root canal is largely determined by the quality of implementation of previous endodontic manipulation, and generally determines the outcome of the treatment.
The basic requirement of this stage is a reliable seal of root canals. Before filling channels are dried with paper points.
To fill root canals gutta percha and pasta are used. Percha is a rubber material, which is produced in the form of cones, the size and shape of the gutta percha match the shape and size of the files, with which we clean out the root canals.
Cones of gutta-percha are covered by pasta and put into the root canals of the tooth. The several cones are introduced in order to get a good seal in root canals.
After the sealing of the root canal, the dentist places a temporary seal on the hole that was made for advances in root canals.
The channel must be sealed to the top without voids or defects.
Then a person should make next appointment, during which the dentist puts a permanent seal.
Restoration of teeth after endodontic therapy
After the treatment of the root canal, the dentist chooses the way of tooth restoration. Restoration of teeth after endodontic therapy is performed in several ways: filling by composite materials (suitable tooth-colored) fillings with composite materials with the pins or crowns.
The fact is that in many cases during the endodontic therapy tooth loses quite significant amounts of dental tissues. This is due to large old fillings, because of extensive decay or breakdown of the crown, etc. The teeth in this state are not strong, and the dentist will decide on the adequate restoration of teeth.
The issue of restoration of the teeth that have lost a significant amount of hard tissue is solved using fiberglass posts.