What Is Endodontic Treatment?
Endodontic treatment involves the removal of infected or inflamed pulp from inside the tooth. The pulp is the soft tissue inside the tooth that contains nerves and blood vessels. When the pulp is damaged due to decay, trauma, or repeated dental procedures, inflammation or infection can occur, causing pain and swelling. If left untreated, the infection may lead to an abscess and eventual tooth loss.
The Goal of Endodontic Treatment
The primary goal of endodontic treatment is to preserve the natural tooth. When the pulp tissue inside the tooth becomes infected or inflamed, the patient may experience severe pain, sensitivity to temperature, gum swelling, and other unpleasant symptoms. If untreated, the infection can progress to an abscess and ultimately result in tooth loss. Endodontic treatment removes the infected pulp, disinfects the interior of the tooth, and seals it to prevent bacterial penetration and reinfection.
The Endodontic Treatment Process
The endodontic treatment process begins with diagnosis and treatment planning, followed by the application of local anaesthesia to ensure patient comfort. A small opening is then made in the crown of the tooth, allowing the dentist access to the pulp chamber and root canals. The infected pulp is carefully removed using specialised instruments, after which the root canals are thoroughly cleaned and disinfected to eliminate any remaining bacteria. Once prepared, the canals are filled with a biocompatible material such as gutta-percha to ensure complete sealing. Finally, the opening in the tooth crown is closed with a filling, which may be temporary or permanent, depending on the restorative needs of the tooth.
Rotary Root Canal Instrumentation Technique
The rotary root canal instrumentation technique represents an advancement over traditional methods that relied on manual instruments. This technique uses specialised machines with rotating instruments for faster and more precise cleaning and shaping of root canals. The advantages of rotary instrumentation include a higher level of precision, shorter treatment time, and a reduced risk of complications.
Materials Used for Root Canal Filling
After the canals have been thoroughly cleaned and shaped, they are filled with biocompatible materials that ensure a hermetic seal. The most commonly used material is gutta-percha, a rubber-like substance used in combination with sealers to achieve complete canal sealing. This material is safe, effective, and compatible with tooth tissues, providing long-term protection.
Biocompatible root canal filling materials are designed to interact with hard dental tissues and stimulate tissue regeneration. They exhibit antimicrobial, osteoconductive, and osteoinductive properties, as well as the ability to induce dentinogenesis and cementogenesis (processes involved in the regeneration of bone and dental structures). Examples of such materials include bioceramics and MTA, which are routinely used in dental treatment at Esthetic Dental Center.
Kako prepoznati bol zuba koja zahtijeva liječenje?
Tooth pain can be very unpleasant and is often a sign that something is wrong. Recognising symptoms early can help you seek dental care promptly and prevent more serious problems. Here are signs of tooth pain that may require treatment:
1. Sharp, Sudden Pain
Sudden, sharp pain that comes and goes may indicate tooth decay or a crack in the tooth. This type of pain often occurs during chewing or exposure to hot or cold foods and drinks.
2. Constant, Throbbing Pain
Persistent, throbbing pain may indicate an infection or abscess. This type of pain is often accompanied by gum swelling and may require urgent endodontic treatment due to the risk of rapid worsening of acute inflammation.
3. Sensitivity to Hot and Cold
Increased sensitivity to hot or cold food and beverages may be a sign of enamel damage, tooth decay, or exposed tooth necks. If the sensitivity does not subside after a few seconds, consult your dentist.
4. Pain When Biting
Pain during biting or chewing may indicate a problem with the tooth root or cracks in the tooth. This type of pain can also be related to issues with fillings or crowns.
5. Swelling and Redness
Swelling and redness of the gums around a painful tooth often indicate infection. This condition can escalate quickly and requires urgent dental intervention.
6. Radiating Pain
If tooth pain radiates to the ear, jaw, or cheek, it may indicate a more serious infection or root-related issue. This type of pain often requires endodontic treatment.
7. Changes in Tooth Colour
If you notice a change in tooth colour, especially darkening, it may indicate internal injury or infection that requires treatment. Such changes are often accompanied by pain or discomfort.
When Should You Seek Dental Care?
If you experience any of these symptoms, it is important to visit a dentist as soon as possible. Early diagnosis and treatment can prevent serious complications and help preserve your dental health.
Case Example from Practice
A patient presented with persistent pain accompanied by swelling due to inflammation of a lower first molar. The tooth had been unsuccessfully treated over several months (repeatedly opened and closed without proper endodontic therapy). The patient was extremely distressed and began experiencing issues related to frequent use of antibiotics and analgesics.
Immediate endodontic treatment was initiated. Lower molars typically have three or four root canals containing nerves and blood vessels (pulp). To save the tooth from extraction and stop the destruction of surrounding bone, all canals must be located, cleaned (instrumented), and sealed. In this particular case, as many as five canals were found and treated—something that would have been extremely difficult without modern equipment and precise procedures (rotary instrumentation techniques, electronic apex locator for determining canal length, magnification loupes, and specialised irrigation and obturation protocols).
In just two visits of 45 minutes each, the tooth was saved and restored, relieving the patient of pain and discomfort and avoiding the significant costs associated with replacing an extracted tooth.
