What is an endodontic treatment and why do teeth need it?

Endodontic treatment is a treatment inside the tooth, which is required in the treatment of complicated caries, as well as in preparation for prosthetics. Penetration of microbes from the deep carious cavity into the pulp causes its elimination and toxic decomposition (decay) of the neurovascular bundle, in the process of which we feel strong aching, night aches, and pains from temperature stimuli.

However, inflammation of the pulp can be for other reasons, such as a tooth injury. It happens that the process of infection of the tooth pulp is long and almost asymptomatic. In such cases, and when we have not treated the tooth and drowned out the symptoms with painkillers, inflammation flows smoothly into the next stage. During inflammation of the neurovascular bundle of the tooth has a toxic effect and ensures the introduction of pathological microorganisms beyond the hard tissues of the tooth.

First, the ligaments surrounding and holding the tooth in the hole (fibrous periodontitis) become inflamed, and then with the accumulation of decay products at the tops of the roots, there is destruction and purulent melting of bone tissue (granulating and granulomatous periodontitis, radicular cyst). This condition is usually accompanied by the fact that we feel pain when loading the tooth, that is, when biting, and in the acute stage even when touching the tooth.

What is the endodontic treatment?

First of all, it depends on the localization of the inflammatory process, in other words, on the diagnosis. When inflammation is localized in the tooth chamber, and the tissues surrounding the tooth are healthy (diagnosis pulpitis), it is enough to anesthetize, purify the carious cavity from softened and infected tissues, form access to the pulp chamber of the tooth, where the inflamed neurovascular bundle is located. Then, special tools are used to remove the pulp, including from the root canals of the tooth. The channels are cleaned by mechanical and medical treatment with various instruments and antiseptics, after which the expanded and treated channels are filled with filling material. Biocompatible materials are used, which provide sealing of root canals. All these manipulations prevent the penetration of infection into the tissues surrounding the tooth. After that, the crown part of the tooth is restored.

And what if the inflammatory process has penetrated further (diagnosis of periodontitis, radicular cyst)?

 

At the first stage, the same treatment of the hard tissues of the tooth and the release of the pulp chamber and root canals from the decomposed neurovascular bundle and necrotic masses, mechanical and medical treatment of the root canals. The next stage of treatment is aimed at eliminating inflammation and restoring the surrounding tissues.

For this purpose, various medications are used, possibly in combination with physiotherapy procedures. This is a longer treatment up to 6 months, the success of which depends not only on the severity of the lesion but also on the overall state of immunity. After any endodontic treatment, dynamic monitoring of the tooth condition is necessary. To do this, x-ray control examinations are made in 6, 12 months, then once a year. Thus, timely modern endodontic treatment allows you to save those teeth that previously dentists had to remove.

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