Root canal treatment
The development and evolution of root canal treatment
Teeth are living organs. They are composed of an outer layer of enamel, more or less two millimeters thick, an inner layer of dentin, seven to eight times softer than enamel, around three millimeters thick and, under that layer are the nerves and blood vessels. If the nerves and vessels are affected by decay or trauma, the tooth becomes sensitive or infected.
In the past, we had no choice but to remove a tooth with an affected nerve. But, with the development and evolution of root canal therapy, we can predictably restore it in the long term.
This treatment often allows us to prevent the loss of a tooth, by completely cleaning and disinfecting its interior and sealing it. The tooth must then be repaired and protected with a crown (see crown section).
How to know if root canal treatment is recommended?
Several factors are evaluated to determine whether root canal treatment is recommended. Often the symptoms are the most important factors. A dental nerve, also called dental pulp, affected by decay or trauma, becomes inflamed and painful. That is called pulpitis. Pulpitis can be reversible or irreversible. Reversible pulpitis can often be treated without root canal treatment, depending on its cause. Irreversible pulpitis requires root canal treatment.
What is a root canal treatment?
Quite simply, a root canal treatment involves disinfecting the internal space of the tooth and sealing it. It is a treatment that requires high precision and a lot of rigor.
The dentist begins by planning the case with the help of 2D x-rays. Sometimes a 3D x-ray scan of the tooth is required. This step is more essential for molars, as they have multiple canals to process and are more complex in shape than anterior teeth.
Before starting the treatment, the dentist must anesthetize the tooth to ensure complete comfort of the patient. Then he applies the dental dam, a rubber sheet, which serves as a barrier to isolate the tooth from the rest of the mouth. He accesses the internal space of the tooth, the pulp chamber, by carving an access cavity with the high-speed electric handpiece. He finds the canal (s) to be treated and starts to clean and disinfect them.
The success of the treatment depends on several factors. It is essential to find all the canals of the tooth. A molar can have up to four, and rarely even five canals. The dentist meticulously measures each canal using an endodontic file and a special machine, the apex locator, which helps him find the tip of each canal quickly and precisely.
He then shapes and irrigates the canals to properly disinfect and seal them. We use a state-of-the-art reciprocal mechanical preparation system called TF Adaptive from Sybron endo, one of the most reliable, safe and efficient systems available today.Finally, the tooth is restored with a composite reconstruction, with or without a post, which will serve as the base for the crown which is necessary for the protection and final restoration of the tooth (see crown section)
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