Endodontics is a branch of dentistry concerned with diseases and injuries of the dental pulp, which is the soft tissue inside a tooth. Endodontic treatment is necessary when inflammation is diagnosed in advanced tooth decay, gangrene or necrosis of the dental pulp.

Root canal treatment involves the removal of diseased or dead root pulp, which includes blood vessels and nerves. Infected pulp is the cause of many dental diseases and related to its symptoms. The next step is to thoroughly clean and tightly fill the empty root canals to prevent bacteria from multiplying, and sealing off the tooth from further decay. The anatomy of the canals, their small diameter, curvature and network of very fine root canal branches can make the treatment difficult and challenging. But trained and experienced endodontists and modern equipment can make even the most complicated treatment possible. Contemporary endodontics have seen an unprecedented advance in both technology and materials.

Root canal treatment step-by-step

Typical procedure of the root canal treatment consists of the following steps:

  • Diagnosis and treatment plan based on X-rays of the diseased tooth as well as intraoral and extraoral examination
  • Anesthesia of the tooth for pain-free procedure
  • Removal of diseased pulp and thorough cleaning of the root canals along their entire length
  • Tight closure of the root canals by filling them with a rubbery substance called gutta-percha
  • Tooth restoration -depending on the treatment plan, the patient will either get a filling or a temporary crown. In case of a filling, this is the final step of the procedure. In case of the temporary crown, the impressions are taken earlier and are sent off to a lab, where technicians create a final crown that matches the natural contours of the tooth.

Endodontic treatment is carried out under the guidance of radio-visiography, which allows to determine the length and shape of the canals. A specialized X-ray machine is used for this purpose, which makes it possible to immediately receive an X-ray image directly on the monitor or perform a computed tomography.

The dentist exposes and then cleans and prepares the root canals of the tooth with specialized tools. To thoroughly clean the canals, chemical rinses are additionally used, which have bactericidal properties. The endodontic treatment procedure requires precision, patience and experience of the dentist. Root canals can be extremely narrow and require very thin surgical instruments to be used. Modern endodontic surgery uses the dental operating microscope and incorporates cone-beam computed tomography (CBCT). Endodontic microscope with a high magnification enables dentists to perform the treatment with optimal accuracy and high chances of success rate.

A properly endodontically treated tooth will continue to perform its function for many years, and modern methods increase the effectiveness of the treatment. A key factor influencing the success of root canal treatment is the proper restoration of the tooth. It is also very important to fill the cavity tightly, and if this is not possible due to too much damage to the tooth – to perform a prosthetic restoration. Treatment may require fitting of an inlay, onlay or crown, to prevent cracks in the walls of the weakened tooth.

Do you have a toothache or do you think you may need a root canal treatment?