Did you know…? That more than 7 million root canal treatments are now carried out every year in Germany alone! Root canal treatments are necessary when the inner tissue (the pulp) of the tooth becomes diseased.
Root Canal Treatment
With our modern equipment and methods in root canal treatment, it is almost always possible to work on obliterated (severely narrowed or overgrown) root canals or a curved tooth root and thus preserve the teeth in question. Even for the removal of old incomplete root fillings, there are special instruments for a renewed preparation (revision).
What used to be a frequent reason to extract a tooth can be avoided with modern instruments and equipment in endodontics.
Root Canal Treatment Procedure
In case of acute inflammation (pulpitis), local anaesthesia is of course given. But anaesthesia is not always necessary. To gain access to the pulp cavity, an opening must be drilled into the crown of the tooth. Then the pulp cavity and the root canals are cleaned up to the root tip with the finest root canal instruments. To do this, the files are used to scrape off the bacterially infected dentin on the inner walls and prepare it accordingly to reach the root tip. This is because the canals branch out here and these branches are the breeding ground for infections.
Once the root canal has been prepared to the root tip, it is cleaned and disinfected. A medical insert is placed in the root canal as a temporary root filling and provisionally sealed. This procedure can be repeated several times if necessary.
As soon as the tooth is free of symptoms and inflammation, it can be sealed with a permanent root canal filling. After root canal treatment, the tooth often has to be rebuilt. Depending on the initial situation, there are various treatment options – from a filling, to post abutments anchored in the root, or a crown.
The aim of a root canal treatment is to preserve the tooth permanently...
We achieve this by:
- Complete removal of the diseased pulp tissue including all germs and necrotic material from the root canals.
- Uniform preparation of the root canal walls
- Preparation up to the root tip
- Preservation of the structure around the root tip through healing of the inflammation
- Bacteria-proof, permanent sealing of the root canals with biocompatible materials
Bildquelle: © Initiative proDente e.V.
Root-treated teeth - dead teeth - Is this a problem?
No. The pulp tissue is responsible for tooth development and growth. The fully formed, “adult” tooth can remain in the mouth without the pulp, because it continues to be supplied by the bone tissue surrounding it. After a successful root canal treatment, there are no more centres of inflammation in the tooth. The bone around the tooth can regenerate again. The healing of the bone can also be seen radiographically after a few weeks.
FAQ - Frequently asked questions about root canal treatment
What means root canal treatment?
The technical term is endodontics. Which is made up of the medical terms endo (inside) and odont (tooth). Inside the tooth is the pulp. This is a tissue that consists of blood vessels, nerve fibres, lymph vessels and also connective tissue.
The main function of the pulp is the development of the tooth during tooth growth. Once tooth growth is complete, the pulp cavity continues to diminish. Often the pulp cavum also obliterates (grows together) with age. The fully formed tooth can also remain in the oral cavity without a tooth nerve, as it continues to be supplied by the surrounding bone tissue.
Can a tooth be conserved through root canal treatment?
Yes, it can. The cause of the inflammation – the infected pulp tissue – must be removed and the root canal cleaned. For this, the root canal must have been prepared up to the root tip in order to completely mechanically remove the bacterial infection and, at the end, be completely sealed up to the root tip with a definitive root filling.
Does the root canal treatment hurt?
A question that can only be answered directly before the treatment. As a rule, the treatment itself does not hurt. Rather, there is a real relief when opening the tooth, as the pressure built up by the inflammation can finally escape. If the tooth nerve is still vital, an anaesthetic can reliably eliminate any pain during the treatment.
After the first treatment, the tooth can sometimes still hurt a little. The medical inlay sometimes has to show its effect first by fighting the inflammation around the tooth. Sometimes it also needs to be renewed. Its effect always depends on the severity of the inflammatory process and the general condition of the patient.
The root-treated tooth may still feel slightly different after the treatment, even after the final treatment. However, this feeling usually disappears in a few days.
When does root canal treatment have to be done?
Root canal treatments are necessary when the inner tooth tissue has become inflamed by invading bacteria or it has even died and the inflammation has migrated into the surrounding jawbone.
How does inflammation of the pulp / tooth nerves occur?
There are many reasons why a tooth nerve can become inflamed:
- carious defect, up to the pulp
- Periodontitis – gum pocket up to the tip of the root
- Tooth fracture / crack through the tooth to the pulp
- Trauma – by which the tooth nerve is damaged
- Stimuli: mechanical, thermal or chemical
What happens if an inflamed pulp is not treated?
The penetrated bacteria inflame the pulp tissue and the root canal system. This can be followed by an inflammation of the periodontium, a so-called periodontis apicales.
Often the tooth already reacts beforehand with increasing pressure pain. But acute toothache caused by other stimuli is also possible, such as in response to cold, heat or even completely spontaneous and long-lasting pain.
Pulpitis can also be asymptomatic, in which case the inner tooth tissue dies unnoticed. Such teeth can be diagnosed with X-rays, vitality and percussion samples.
The consequence of untreated pulpitis is usually inflammation of the surrounding bone. At any time and without warning, such teeth can cause severe pain. Physical exertion, changes in temperature or even air pressure (aeroplane, mountains) can lead to sudden attacks of pain or aggravate existing mild pain.
What are the alternatives to root canal treatment?
Once the pulp of the tooth has been permanently damaged, the only alternative to root canal treatment is tooth extraction. However, this tooth gap should be closed again to ensure the chewing function. The neighbouring teeth can also be overloaded by the resulting misalignment.
Are all teeth suitable for root canal treatment?
Almost all teeth can be root canal treated. As long as the roots are still firmly anchored in the bone and the root canal is accessible. Contraindication is often a root fracture, too little bone substance or if a subsequent build-up is no longer possible. However, in today’s dentistry there are many treatment options for preserving teeth.
If a root canal treatment does not lead to complete healing, there are also other treatment options, such as a revision treatment or, if necessary, a WSR (root tip resection).
However, root canal treatment can also lead to complications. These include root fractures due to overloading of the tooth, inaccessible canal sections or particularly persistent microorganisms that can penetrate deep into the dentibuli and survive as a monoinfection. The success of the therapy is also made more difficult if the tooth is also loosened in its bone compartment due to gingivitis. And sometimes broken instruments also block access to the preparation.
After successful root canal treatment - What happens next?
Root-treated teeth can become somewhat unstable if they have lost a lot of substance. Often a new covering filling is sufficient. Particularly heavily loaded teeth should be provided with a root post build-up and a crown for better stability, if necessary.
Innovative Treatment Concepts, sensibly planned treatments and optimal dental restorations enable us to keep your teeth healthy even into old age.
Tooth preservation is always in the foreground with us!
Untreated periodontitis not only causes loose teeth, but is also a risk factor for heart, diabetis...
More quality of life with new dentures through a natural smile and the ability to bite powerfully again.