Root canal treatment (Endodontics)

Root canal treatment (Endodontics) is based on manual and mechanical cleaning and removal of diseased root canal tissue and their tight sealing. The reasons for undergoing canal therapy are as follows: irreversible pulp infections or gangrene, otherwise known as tooth pulp atrophy. The most common reason for the development of tooth pulp disease is a bacterial infection. It can be caused by:

• entry of microorganisms into the tooth pulp from the side of the crown (through untreated cavity in the tooth or old, damaged, porous filling), from the side of the root or through pathological pockets in cases of parodontic teeth,
• tooth damage, causing a break in the angio-neural bundle that feeds the tooth,
• pulp atrophy without the presence of cavities.

1. The above drawing depicts a tooth, in which pulp atrophy has occurred. In the next, because of a long term infection of the pulp, changes in the area near the top are evident. This has occurred because of the entry of bacteria through a cavity.

2. This type of cavity has to be treated under local anesthesia, without further exposure to saliva and bacteria. In order for this to be possible, a rubber dam is used, it is a special rubber leaf mounted on the tooth with the help of small clamps and kept in place with the use of a plastic or metal frame. After cleaning of the tooth fissure, the flow of the canals has to be located, they need to be widened and very carefully and precisely rid of the dead or infection-damaged tissue. This type of work is performed with the help of manual and mechanical tools specifically shaped for canal work, and with the use of many disinfecting solutions and preparations. These are used in large quantities, in order to accurately remove bacteria and the diseased tissue extracted by the canal tools. In order for these treatments to be precise, and so as to cover the entire length of the root canal, an apex locator (a tool designed to measure the length of the root canal) is used during the procedure. The entire work is controlled with the help of dental X-rays.

3. After a thorough cleaning and disinfection the root canals are fully dried, and filled with the use of gutta-percha along with a small amount of sealant. Methods that guarantee the best tightness of the filling are:

• manual side condensation - based on the precise stuffing and condensing of gutta-percha cones (precisely sized and adapted to the width of the canal)
• filling of the root canals with the help of liquid gutta-percha (with the help of Obtura and System B equipment)

The quality of the filling is then controlled with the use of X-rays.

4. The last phase of treatment is a lasting and tight reconstruction of the