Root canal treatment / Endodontics

Inside the tooth, beneath the very hard enamel and a somewhat less hard layer called dentin, there is a soft tissue known as the pulp. It contains blood vessels, nerves, and connective tissue and extends from the tooth crown to the root tip. The pulp is important for tooth growth and development. However, the fully developed tooth can remain in the mouth without the pulp, as it continues to be supported by the surrounding bone tissue. A root canal treatment becomes necessary when this pulp is inflamed or infected. This can have a variety of causes, such as cavities, thermal or chemical stimuli, a crack in the tooth, or an accidental injury. If the inflammation of the pulp is not treated, it can lead to both pain and inflammation and to the suppuration of the jawbone.

1. The dental crown is opened and the nerve cavity (pulp chamber) is cleaned. Subsequently, the root canals are located and expanded with small files. 2. This "expansion" allows for the cleaning and disinfection of the entire root canal system using irrigation solutions. The placement of medication in the root canals supports disinfection and can promote healing. 3. After shaping, cleaning, and disinfection, the root canals are filled with a plastic, sealing, and biocompatible root filling material. 4. A tight seal of the access opening should prevent reinfection. 5. For the long-term preservation of the tooth, the dental crown is restored with the appropriate tooth preservation method. The inflammation at the root tip should now heal.

1. The tooth crown is opened and the nerve cavity (pulp chamber) is cleaned. Subsequently, the root canals are located and expanded with small files.
2. This "expansion" allows for the cleaning and disinfection of the entire root canal system using solutions. The insertion of medication into the root canals supports disinfection and can promote healing.
3. After shaping, cleaning and disinfecting, the root canals are filled with a plastic, sealing and biocompatible root filling material.
4. A tight seal of the access opening should prevent re-infection.
5. To ensure the long-term preservation of the tooth, the tooth crown is restored with the appropriate preservation method. The inflammation at the root tip should now heal.

Procedure of a root canal treatment

The initial root canal treatment is usually performed in one or two sessions. During this time, the tooth is locally anesthetized. Afterwards, a small, elastic rubber dam is placed on the tooth to keep it free from saliva and bacteria during the treatment. The tooth crown is opened from above, and the nerve cavity is cleaned. Subsequently, the root canals are expanded with fine files. Then, the doctor cleans and disinfects the entire root canal system. Magnifying glasses or surgical microscopes are very helpful for the individual steps to recognize the fine and highly branched anatomy of the root canals. After disinfection, the hollow space in the root is filled with a sealing material. Finally, the access in the tooth crown is closed with a bacteria-proof and stable filling. Once prepared in this way, the tooth can then be fitted with a crown.

Risk of a root canal treatment

The root canal treatment brings significant pain relief caused by an inflamed nerve. Most patients treated with modern technology and local anesthesia report feeling little or nothing during the treatment. However, in the first few days after the treatment, the treated tooth may react sensitively. In rare cases, despite careful treatment, bacteria can remain in an inaccessible lateral canal, leading to a recurring chronic inflammation of the bone. This is treated with a revision of the root filling or an apicoectomy.

After the root canal treatment

The advantage for patients, in addition to avoiding general anesthesia, is also the shortened healing and recovery phase: Usually, only a break of one instead of three weeks is required – then patients can resume their usual daily lives.

"The prerequisite for overall success is always," according to the experts of the Premium Medical Circle, "a holistic observation and approach. The focus is on taking into account the entire, individual personality and the wishes of the patient. The entire therapy is aligned with this – from the first consultation to follow-up care."