Root canal treatment

Endodontics (root canal treatment) is a branch of conservative dentistry dealing with the diagnosis and treatment of dental pulp disorders and periapical tissue diseases. The term “endodontics” comes from the Greek words “endo” – inside and “odont” – tooth.

Endodontic problems are the most common (90%) cause of toothache. They are directly caused by an infection of the dental pulp inside the tooth.

What sets us apart:

• machine root canal cleaning instead of manual cleaning,
• filling canals with thermoplastic gutta-percha using the OBTURA system, as opposed to manual filling used in most clinics,
• root canal treatment using a microscope, as opposed to the naked eye or magnifying glass used in most clinics.

The use of advanced equipment, modern techniques and materials gives us almost unlimited possibilities in endodontic treatment.

Głębokie ubytki próchnicowe:

• prowadzące do tak zwanego próchnicowego obnażenia miazgi,
• powodujące penetrację bakterii do wnętrza zęba i nieodwracalne zapalenie miazgi.

Zmiany endodontyczno-periodontologiczne (tzw. endo-perio):

• niekiedy stany zapalne miazgi zęba i tkanek okołowierzchołkowych prowadzą do zmian chorobowych w przyzębiu (potocznie zwanych paradontozą); zdarza się również, że długotrwałe zapalenie dziąseł powoduje przenikanie bakterii do tkanek otaczających korzeń zęba, powodując zapalenie miazgi zęba.

Urazy mechaniczne:

• złamanie korony zęba z obnażeniem miazgi,
• złamanie korony zęba bez obnażenia miazgi, ale z brakiem możliwości jej odbudowy i koniecznością zastosowania wkładu koronowo-korzeniowego,
• zwichnięcie zęba prowadzące do przerwania pęczka nerwowo-naczyniowego odżywiającego ząb.

Leczenie protetyczne:

• niekiedy podczas leczenia protetycznego, aby osiągnąć planowany efekt, może zaistnieć potrzeba leczenia kanałowego zębów nieprawidłowo ustawionych w łuku zębowym (np. nadmiernie przechylonych czy zrotowanych).

Preparation for the procedure

Endodontic treatment is performed under local anaesthesia.  To increase patient comfort, we use a specialised computerised anaesthetic delivery system called Sleeper One and/or inhalation sedation with nitrous oxide during anaesthesia administration and treatment. Read more about anaesthesia >>

Protecting the treatment area with a rubber dam

Before the procedure, we isolate the tooth with a rubber dam – a thin piece of rubber that prevents saliva and bacteria from entering the treatment area.

Fig. Root canal treatment procedure

Preparation and cleaning of the tooth roots

At this stage, we open the tooth and remove the infected pulp from the chamber and root canals.

Then we prepare the root canals while measuring their length, i.e.:

• we widen the canals using machine and hand tools to remove the infected root dentine,
• at the same time, we use special fluids to rinse the root canals, which help to remove the remains of infected pulp and bacteria.

Root canal treatment under a microscope

Root canal treatment requires extreme precision. For this reason, at the ARTIMEDICA clinic, we usually perform it using a diagnostic and surgical microscope.

The use of a microscope during endodontic (root canal) treatment, thanks to the multiple magnification of the working field and excellent lighting, allows the dentist to:

• locate and treat narrow canals and their branches – especially additional root canals, which are often invisible in traditional treatment, and their possible omission is one of the main causes of endodontic treatment failure;
• perfect treatment and filling of curved canals;
• overcoming obstructions inside the root canal, which is sometimes completely closed;
• removal of broken endodontic instruments, crown-root inlays, hard canal filling cements (during re-treatment);
• correct diagnosis and appropriate root canal treatment in cases of cracks or fractures in tooth tissue that are not visible to the naked eye;
• treatment of root resorption and perforation;
• treatment with crowns and prosthetic bridges without the need to remove and destroy them.

Root canal filling

After preparing and cleaning all tooth canals, they should be filled with a biocompatible material called gutta-percha and the root canal openings should be protected before the next stage of treatment – tooth crown restoration.

At the ARTIMEDICA clinic, we use only thermoplastic gutta-percha filling technique in endodontic treatment, using the OBTURA system – the leading manufacturer of endodontic equipment.

In order to restore full functionality and aesthetics of the tooth after root canal treatment, we rebuild it:

• with composite material,
• inlay, onlay or overlay filling – in the case of significant damage to the tooth crown.

In the case of complete loss of the natural tooth crown, it may be necessary to use a crown-root inlay and a prosthetic crown.

Endodontic treatment revision (known as re-endo), i.e. re-treatment of a tooth canal, is performed in the following cases:

• an X-ray shows changes in the bone that have not healed after previous root canal treatment,
• the X-ray shows a leaky filling in the root canals,
• the already filled canals have become infected by caries in the crown of the tooth.

Repeat root canal treatment is more complicated and therefore carries a higher risk of failure than the initial endodontic treatment. It involves removing the filling material from the canals, cleaning them again and refilling them with a new sealant.

In some cases, the dentist cannot perform root canal treatment due to:

• lack of access to the canals,
• root fracture,
• inability to tightly restore the crown.

Significant technological advances in this field – new-generation devices, tools, techniques and materials – minimise such cases and allow us to save teeth that would have been doomed to extraction just a few years ago.

However, even if a tooth needs to be extracted, modern dentistry still allows us to fill the gaps in your dentition while fully preserving functionality and aesthetics.

This is possible thanks to the use of treatments in the field of:

• implantology,
• prosthetics.

After endodontic treatment, as after basic conservative treatment, it is necessary to maintain proper oral hygiene by:

• brushing daily,
• daily cleaning of interdental spaces (with dental floss, irrigator, etc.)
• regular dental check-ups, at least every 6 months,
• undergoing regular preventive treatments at the ARTIMEDICA clinic.