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The root canal treatment
The main aim of endodontic treatment is recovery of function of health tooth. It’s applied if there are acute and chronic pulpits and all forms of periodontitis. Endodontic treatment involves opening the tooth, removing the damaged pulp, cleaning, shaping, filling and sealing the tooth. Depending upon how much infection there is in the injured tooth, your may be put on medicine before your dentist or Endodontist can begin to work.
The dental pulp is the central part of the tooth filled with soft connective tissue. This tissue contains blood vessels and nerves that enter the tooth from a hole at the apex of the root. The coronal pulp has the same relief as crown.
The pulp of root canals differs from the coronal pulp. There are more collagen fibers which create fascicle.
The pulp is commonly called “the nerve” of tooth, indeed it consist of arteries, veins, vessels of lymph and connective tissue.
The pulp of tooth has very plentiful blood supply.
The root canal
Inside of tooth is the cavity, which subdivides into cavity of crown and root canal.
The surface of cavity, where root canals are begun, is called floor of cavity.
The root canal is begun by funnel mouth on the floor of cavity, goes along longitudinal axis and it is finished by visible hole on the root apex or near by it.
The pulpitis is an inflammation of tooth pulp.
Inflammatory process in the pulp arises because of irritants, what come from carious cavity. There are such kinds of pulpitis as initial, acute, suppurative, chronic and chronic-hyper plastic pulpitises.
For the initial pulpitis is typical of hyperaemia, where is increased blood flow into small arteries of pulp. Increasing of blood into the pulpal cavity creates pressure of nerve fibers, and causes small pain. After removal of irritate, painful sensation are kept during 1-1,5 min.
If the pulp can’t be restored itself, and irritates continue, in this case come irreversible processes. There appear acute or dull, pulsed or constant, topalgia or diffuse pain.
The suppurative pulpit is the difficult form of acute pulpitis, which is accompanied by acute, insufferable pain, which becomes stronger at the night. Under the examination, there are found carious cavity and painful floor of cavity during drilling.
The chronic pulpitis is accompanied by an attack during act of irritates, when irritates are removal, the pain is stopping systematically. Periodical dull pain can continue long time. Under the examination there are found deep carious cavity, gingival hemorrhage.
The chronic hyper-plastic pulpitis is irreversible form of pulpitis, it’s often found in the children and young people with difficult caries. It’s chronic pulp inflammation, which is presented by hyper-plastic pulp tissue, it is called polyp of pulp.
Pulp necrosis is one of irreversible form of pulpitis, and it’s presented by pulp dying. It arise as result of long term bacterial invasion or as result of acute suppurative pulpitis.
Основные этапы эндодонтического лечения
During root canal treatment is necessary to keep procedure.
After anesthetic procedure, the dentist isolates the tooth from saliva thanks to putting thin leaf of rubbing around tooth, the leaf is called cofferdam. It’s kept by small clamp which is attached to tooth. Full isolation is necessary for avoiding ingress of bacteria from saliva into root canal during root cleaning.
Access to canal is provided by right preparation of carious cavity, moving off roof of pulp, creating free access into canal for endodontic instruments.
Root canal cleaning includes mechanical and chemical disinfection. On this stage is important to remove bacteria, pulp tissue, which can be infected.
Handling is made along root canal to the top of root, but not out.
That’s why is important define root canal length. For this the dentist put files into and then makes X-ray picture, and according it is defined root canal length.
The dentist makes chemical disinfection by irrigation of canal with disposable needles.
After root canal cleaning, the dentist starts to make root sealing.
Canal filling is the last stage of treatment. The success of root canal filling depends on previous endodontic manipulations.
The main condition for this stage is reliable sealing of root canal. Before sealing the canals are dried paper post.
For root canal filling there is used gutta-percha and paste. Gutta-percha is rubber material, which is produced like cone. The size and the form of gutta-percha conform to the form and size of file-instruments. Cones of gutta-percha are covered by paste and put into root canal. For good sealing, in root canal are put a few cones into.
Guttapercha point and especial paste
After root canal filling the dentist puts temporary filling in. The canal must be sealed to the top without emptiness and defects.
After, there is made next appointment, where a dentist put permanent filling in.
Tooth restoration after endodontic therapy.
После окончания лечения корневых каналов, врач-стоматолог решает вопрос восстановления зуба. Восстановление зубов после эндодонтической терапии осуществляется несколькими путями: пломбирование композитными материалами (подходящие под цвет зуба), пломбирование композитными материалами с помощью штифтов, использование коронок.
At the end of root canal treatment, the dentist decides to make or not tooth restoration. There are a few ways of tooth restoration after endodontic therapy: stopping by filling materials (according to tooth color), stopping by filling materials with posts, using crowns.
The fact is that during endodontic therapy thetooth lost considerable part of tooth tissue. It happens because of big old filling, spacious caries, or breakdown of crown and so on. For this condition the tooth becomes frail, and dentist has to decide the way of tooth restoration.
For difficult situation, when the tooth lost a lot of hard tissue there is used root post.
Root post (anchor post)- is pin which is made of metal and installed into root.
For post installing the dentist, remove some gutta-percha for getting space for it. Then he fixes the post into root canal, and then on the top of tooth is put filling material on for creating anatomical tooth form. In such way the dentist, strengthen the tooth, which already doesn’t have a lot of hard tissue. But sometimes it’s not possible to reach adequate durability even with help of post or filling materials. In this case, the artificial crowns are put on the tooth.