Endodontics is the specialist area of Dental Medicine aimed at treating pulp pathologies (commonly called the nerve )
Dental pulp is located inside the tooth and is surrounded by hard tissue – dentin – being responsible for dental nutrition and sensitivity by way of the constituent blood vessels and nerves.
Dental pulp lesions may originate from traumatisms, fractures or deep caries. Indicative symptoms of an endodontic problem include spontaneous pain, prolonged sensitivity to cold and/or heat and discomfort to the touch and chewing and one of the most common signs may be the presence of an abscess or fistula (small ball of pus on the gum).
In cases of necrosis or irreversible inflammation of dental pulp, endodontics (root canal treatment) is the only solution to save the tooth and avoid other complications.
As well as eliminating the pulp pathology, endodontic treatment allows, in conjunction with the subsequent reconstruction, the chewing function to be returned to the tooth. There is also the possibility of carrying out endodontic retreatment which consists of a new treatment of the root canal system. It shall always be the first treatment option in teeth whose previous endodontic treatment has failed. With retreatment, all of the existing content inside the root canal system is removed, carrying out a new cleaning and shaping and three-dimensional filling.
- Removal of pulp tissue
The first step in endodontic treatment involves the removal of the infected or necrotic pulp. Under local anaesthesia and using appropriate burs, an opening is made in the back of the affected tooth, in the case of an anterior tooth, or in the crown in the case of the molar or pre-molar teeth, whereby all the tissue or remains of obturation material from previous endodontic treatments is removed from the dental pulp.
- Irrigation (disinfection) and obturation of the root canals
After removing the pulp or remains of the obturation material from previous endodontic treatments, the pulp chamber and the root canal system to be found in the roots are duly disinfected with a view to eliminating all the bacteria. Once the root canal system have been suitably shaped, they are ready to receive filling, generally speaking carried out using Gutta-Percha and sealer. Once the canals have been filled, the tooth is restored in such a way as to reacquire the natural appearance.
Since the duration of the endodontic treatment depends on various factors, in those situations in which it is not possible to carry out complete treatment in just one appointment, provisional restoration is placed in the access opening with a view to protecting the tooth between appointments.