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Tooth Root Canal

The A – Z of Tooth Root Canal

Tooth Root Canal

Tooth root canal treatment is a necessary step of dental treatment to maintain the teeth. Therefore, I would like to briefly explain what this treatment means for you. If the nerve of a tooth is inflamed or even dead, there are ways to protect the tooth from extraction. With a successful root canal treatment, inflamed or dead teeth need not always be drawn.

These so-called endodontic measures can often preserve the tooth. The aim of each root canal treatment is to remove the inflamed tooth mark (pulp), to free the inner life of the tooth from tissue fragments and germs, and then to close the cleaned root canals in a bacteria-tight manner.

 

Reasons for root treatment

A root canal treatment is necessary when the pulp ( “nerve”) of a tooth is inflamed or already dead, which is often expressed in pain, but can also be completely unnoticed and accidentally discovered in the cold test or randomly in the X-ray image Caries, which are infected by the tooth substance, can also cause an overloading of teeth, a periodontal disease, or a loose root, which is the cause of an inflamed or dead pulp, and it is often necessary to remove and replace old root fillings are insufficient or leaky and are the cause of an inflammatory process. The cause of the inflammation of a tooth or more precise of the tooth is usually deep caries. Bacteria penetrate from the outside into the tooth bone and damage the tooth mark (pulp). The consequence: an inflammation of the tooth nerve (pulpitis), which leads to the death of the pulp, and ultimately to the surrounding bones and can damage the bone substance considerably.

A violent toothache can be a sign of pulpitis. Inflammation of the nervous system, however, must not always be painful, but can also be quite symptomless. The dentist can then determine them only by means of special examinations (radiographs, vitality tests).

 

Purpose of root treatment

The general procedure for endodontic treatment aims to completely free the fine root canals of a tooth from all tissue residues and germs, to prepare them to a certain diameter, and to fill them tightly to the tip of the root with a well-tolerated material so that no further infection can develop. This is, however, easier said than done. Above all, in the case of hard-to-reach cheek teeth and kinked tooth roots, the limit of treatment is occasionally reached.

 

The Root Canal Process :

 

 

Different initial conditions before root canal treatment

Treatment of the vital, but painfully inflamed pulps and the still living pulp is painlessly removed under anesthesia (local anesthetic) and later replaced by a root filling material. Occasionally slight discomfort may occur for a few hours. A root canal treatment is often complicated and lengthy. The dentist must first get an accurate picture of the degree of inflammation.

X-ray images are necessary for this procedure. Only with this important information can the dentist begin treatment. In any case, the root canal system is cleaned with special small instruments, processed and rinsed with disinfecting solutions. Sometimes, more medicinal deposits are necessary to cure the inflammation. As a rule, the dentist gives the patient a local anesthesia before beginning the root canal treatment.

 

Treatment of a tooth with already dead pulp

Before the root filling, the infected and dead pulp tissue must be removed and the canal system thoroughly cleaned and disinfected several times. The inflammation process present in the tooth and jaw bone can cause slight discomfort for one or two days, which can be controlled by a new rinsing and medication insert into the tooth.

 

Revision and removal of an insufficient old root filling

Incomplete or leaky root fillings can be the cause of chronic inflammatory processes at the root tip, with the spread of germs and toxins into the organism. They must, therefore, be removed and renewed after thorough disinfection of the root canals. This can be an extremely difficult treatment, especially if the old root filling material is hard and additionally cemented root sticks have to be removed. This requires a lot of patience, caution, experience as well as a sophisticated approach with special tools.

 

What is the risk of a root canal that is treated only “adequately”?

A “sufficient” root filling, e.g. – only 2/3 of the root is filled, – is in an incompletely carcass-free or – only partly prepared channel, can lead to the tooth with an inflammation at the root tip over time. Such teeth are often accompanied by chronic pain in the jaw area. There is also the risk that the

Billions of bacteria, which are located in an inflammatory heart, are distributed throughout the body via the bloodstream. Thus, these bacteria present an increased risk of disease for many other organs of the body. These increased risks, as well as the problems occurring directly in the region of the tooth, can often be solved only by the removal of the tooth.

 

Development of the optimized root treatment

The tooth first undergoes a bacterial-dense build-up, in which an existing caries is completely removed. To prevent further bacteria from getting into the tooth through the saliva and to protect you from the ingestion of the very fine instruments or rinsing fluids, the affected tooth is insulated with a rubber bag. The diseased tooth is then opened. Often it is extremely difficult to find the individual root canals of a tooth. Not infrequently, for example, bark teeth have up to four root canals with usually untypical gradients. These can only be visualized and treated with a surgical microscope, as it is used in experienced doctors practice. The surgical microscope alone enables permanent optical control of the individual work steps, which the eye alone could not detect at all.

Doctors check the length of the root canals with an electronic device, which precisely indicates the reaching of the root tip and additionally reduces the number of necessary radiographs.

A key factor for the success of a root canal filling is the previously performed perfect preparation and cleaning of the channels. Therefore, doctors prepare the channels very widely and use an ultrasound-activated, particularly effective rinsing process. For the processing of the channels, they use the most modern, computer-controlled files made of nickel-titanium, which are particularly flexible and flexible. Break resistant. In order to avoid the risk of fracture, these are only used once.

A complete filling of the root canals and the possibly existing lateral ducts can be achieved with the help of an elaborate special technique from the USA, which is called “vertical thermoplastic condensation with gutta-percha”. In addition to state-of-the-art technical equipment and latest materials, the extremely high time required for successful root canal treatment contribute to the dentists success.

 

Risks and possible complications – If the treatment does not lead to success

Despite correct root canal treatment, a new inflammation of the root tip can occur. Through a surgical procedure (root tip resection), the root tips are capped and the surrounding inflammatory tissue removed. Thus the tooth can still be preserved in many cases. If, however, the root tip resection fails, the dentist has no other choice: he must pull the tooth.

Because of the frequently present, pronounced loss of tooth hardness, root-treated teeth are more susceptible to fracture than caries-free teeth. For this reason, such teeth have to be rebuilt very often during a restorative treatment and protected by a cap or partial cap so that stability, function, and aesthetics can be restored. In the case of large substance defects, a root canal must sometimes be anchored in the root canal in order to provide sufficient support for the building material under the cap.

 

Despite great efforts, however, problems may arise during or after treatment:

It is only during the treatment that the tooth cannot be saved and must be removed. During or after treatment, complaints occur on the treated tooth, so that medicines are necessary to support the healing process.

In rare cases, the bacteria continue to grow at or below the root tip despite correct root filling. This is due to the fact that some bacterial strains do not need oxygen for survival (anaerobes). In such a case, the surgical removal of the root tip is necessary with a part of the highly inflamed area surrounding it (root tip resection).

 

Alternatives to root canal treatment

The alternative to root canal treatment is the removal of the diseased tooth! This results in costly and usually considerable cost-intensive subsequent treatments, e.g. Implants, bridges or removable dentures. If there is no treatment, it must be expected that the inflammation will spread to the jaw bone

Pain, swelling, and suppuration occurs and affections Occur.

 

Prospects of root canal treatment

Doctors cannot guarantee you the success of their efforts. Compared to a rate of less than 50% in the case of a conventional procedure, the optimal root canal treatment can be expected to reach a success rate of approx. 90% over a period of 10 years. A correct restoration, a healthy tooth holding device, good home care and regular dental check-ups contribute to this long-term success.

 

Necessary follow-up treatments after successful root treatment

At the end of a root canal treatment, the root canal filling is always present. It closes the cleaned root canals in a bacterial way and protects them from the penetration of new, harmful germs. This is equally important for the access cavity – the so-called “bore hole” to the root canal system.

Finally, it is sealed with a filling. Now the dentist only has to check the root canal filling with the help of the last radiograph, then the treatment is finished. In many cases, root canal-treated teeth are later stabilized by a cap. There is a risk that the tooth will break.

 

Costs for an optimized root treatment

You cannot claim a treatment beyond this “adequate” quality and thus also prognostically more favorable treatment since your health insurance company only takes the necessary extra expenses in rare cases.

The guidelines and timetables of the statutory health insurance funds are from the 1970s. Since then dentistry has developed rapidly, but not the legal requirements. Root canal treatments according to the current scientific knowledge go far beyond the ideas of the health insurance companies regarding time expenditure, material use and success prospects.So before all these happens, go for regular teeth caring with maintaining oral hygiene,  maintain tooth friendly foods, regular dental deep cleaning and all the techniques to save your teeth from gum disease.

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