ROOT CANAL TREATMENT

Root canal treatment importance

Root canal treatment definition – root canal treatment represents the stomatology treatment which addresses disorders (diseases) inside the tooth (of nerve).

Root canal disorders – are those disorders that appear at dental pulp level (nerve) and are composed of inflammation or nerve infection. By performing canal treatment the inflammation and infection mentioned above are removed, thus removing the risk of complications and endodontic disorders.

Endodontic disorder complications – are generated by the failure to treat on time inflammation or infection at dental pulp level (nerve). If a tooth was affected by decay or has suffered a trauma (accident) and hasn’t received proper care, inflamed nerve from the decay or trauma suffers a biological degradation process. Following this process bacteria (microbes) are formed and toxins are disposed that enter the periapical space (tip of the root) causing infection. These infections can lead to a total compromise of the tooth which will have to be extracted. Therefore endodontic disorder complications represent tip of the root teeth infections, being one of the main causes for teeth loss.

Why should we save teeth?

Saving a tooth is important due to the fact that its loss is an event with a general echo in the dentomaxillary system level. A lack of space resulted after extraction leads to an esthetic deficit (if the tooth is placed in the frontal part of the dental arcade) as well as a functional deficit (reduces mastication efficiency) if the tooth is from the lateral area of the dental arcades. Losing a tooth, not followed by prosthetics (replacement of respective tooth) leads to distant secondary complications – occlusion imbalance (mastication) with consequences at the temporomandibular joint level (connection between mandible and skull bones).

Therefore, saving teeth from extraction becomes an important aspect in modern stomatology – minimally invasive. Root canal treatment offers solutions for saving teeth. At the same time it should be noted that there is a limit to which we have to try saving a tooth. All that lies beyond the limit is more harmful and will increase costs to repair what we actually believe we are saving.

A tooth with good implanting (good degree of root insertion into bone) but with profound decay lesion almost reaching the nerve can be properly treated through endodontic treatment and in this case saved from extraction. So, treatment cost through endodontic saving and crown restoring may be lower than that of a surgical treatment for dental implant insertion in the post extraction area.

Endodontic special technology

Technologic evolution has left its mark on this branch of stomatology thus making endodontic treatment a more predictable one (with higher chances of success). Some of the special technologic means with endodontic implementation are:

• Microscope and Lenses (optic amplifying means) – are magnification means which make root canal treatment safer, operator having a higher visibility degree (up to 25 times). Also, lenses and microscope use lighting systems which help the operator to visually perceive the canal almost in its entire length. So, use of magnifying tools removes root canal treatment procedure from the “blind” maneuvers category based exclusively on tactile procedures.
• Digital x-ray which offers highly accurate images at an infinitesimal dose of roentgen radiation.
• Dental tomography which reveals the number of canals, precise and volumetric (tridimensional) and their shape and direction.
• Foramen locator (apex locator) – a digital device which connected to root canal instruments accurately indicates the tip of the root. The operator then knows exactly how far he should perform root canal treatment (root canal filling), thus removing, almost entirely, the risk of incomplete (short) or overcoming canal treatments.
• Isolation and tooth protection means – Dental dam – is a latex field (rubber) in which a perforation is done that will only allow the treated tooth to emerge. This field blocks the rest of the mouth cavity making it impossible for saliva to enter (heavily loaded with microbes) at the root canal level. Thus, the risk of periapical infections secondary to root canal treatments is reduced.The term “diga” comes from the English term “rubber dam” – meaning “rubber diga”. Another advantage in dental dam use is the fact that the doctor is strictly focused on the tooth in question, his attention not being distracted by surrounding anatomic formations.
• Laser in stomatology – laser technology has applicability in root canal treatment, making it an extremely safe and fast one. With laser aid, root canal treatment time is much shorter – nerve excision lasting a couple of seconds unlike the classic procedure where more time was lost. Also, by laser, root canal infections can be treated extremely fast and secure.
• Rotation endodontic engines – are instruments that increase working speed. Using the endodontic engine, the clinician is allowed to treat overly curved canals, narrow canals in record time. Also, through rotation instruments mounted on endodontic engines, root canals are prepared in a tridimensional manner so the next canal filling will be more adapted to the canal.
• Radiology assessment and evaluation systems – we recall in this chapter dental x-ray and computer tomography. By dental x-ray endodontic disorders can be diagnosed. An accurate diagnosis is revealed by computer tomography which reproduces a tridimensional picture of the problematic tooth and bone formations in its vicinity.