Root canal treatment

Regardless of the cause of the treatment, the procedure is always the same. The whole process begins after local anesthetic. The dentist drills into the tooth to remove infected materials. Each root canal is opened by sterile pins and the dentist removes the blood vessels together with the nerves while continuously cleansing the wound to eliminate the risk of a bacterial infection. Further X-ray examinations reveal when the pin reaches the root apex. When filling the canals, it is essential to seal them hermetically by using the most up to date filling materials. The root canal treatment is typically performed in one dental appointment. If the tooth is necrosed, special medicine is placed in the canals to reduce bacterial infections. In this case the canals are capped by a temporary seal and the permanent filling is placed during a second session.

Following root canal treatment, the teeth may be sensitive to masticatory pressure for a few days. Since blood circulation is eliminated in the teeth treated, they dry out and get cracked more easily than before. To prevent their fracture, placing a crown is recommended. Root canal treatment is not always possible in the case of extra canals (multirooted teeth) or irregularly positioned roots.

Information on root canal treatment Intervention

We would like you to feel more secure during the treatment that is aided by the thorough knowledge of schedule, duration, side effects and complications of treatment.

During the consultation, your therapist informs you on the given intervention in details. This informative supply aims at refreshing what has been heard and summarising the answers of the most frequent questions. Please read carefully this handout prior to the initiation of your treatment and in case of any questions or doubt do not hesitate to consult with your therapist.

The purpose of this handout is to provide information for patients and their approval of treatment with full knowledge and informed consent in compliance with Lisbon Declaration of WHO of 1981 and with Act CLIV of 1997 effective in Hungary.

Indication:

  1. When decay reaches deep cavity the tissue is infected and huge amount of bacteria flow to inner part of teeth trough dentin invade. Decay may occur under secondary decay or on not treated dental surface. In most cases, teeth may react to sweat, cold or warm with aching pain, however, in certain cases no complaint is observed. One may clearly see on radiograph that decay extends to dental pulp.
  2. In case of pulpits. It is an infection with ardent and aching pain in dental pulp. It may caused by deep cavity, parodontological processes, traumatic occlusion, chemicals or dental intervention.
  3. In case of necrosis of dental pulp by decay, trauma, periodontical disease, jaw surgery intervention or sometimes correction of teeth irregularities. The process is accompanied by the slow mortification of living tissue. Teeth aches bluntly and of throbbing nature, sometimes very intensively. Pain is normally caused by consumption of warm food or beverages and it is eased by cold. In many cases, however, the necrosis of dental cavity is painless.
  4. In case of inflammation around dental apex (granulocyte, cyst, and other chronic inflammations): necrosis of pulp is due to inflammation around dental apex. Besides blunt ache, occlusion may be slightly or significantly sensitive.
  5. In case of necrosis of dental cavity accompanied by facial swelling.
  6. In case of re-treatment of incorrectly root canal-filled tooth.
  7. Due to inflammation in the bone around the apex of teeth having been root canal-treated.
  8. It is overloaded, therefore inflamed (so-called sterile inflammation) and mortified tooth due to long lasting traumatic occlusion.
  9. In case, during various periodontalorigin processes, it became infected from gingival pocket and root apex and it inflamed or mortified.
  10. In case the dental pulp exposed during dental intervention (upon preparation of socket or stump). In such cases tooth needs preventive root canal treatment due to posterior super infection.
  11. Sometimes, in case of tooth mortified due to orthodontological treatment.

Treatment:

Treatment is performed, depending on the infection of tooth, at one or more occasion under local anaesthesia. Root canal treatment is carried out by the utilisation of a specific isolating set, the so-called rubber dam isolating set. The tool consisting of rubber sheet and fixing clamp is a practical and inevitable condition of successful root canal treatment. It provides complete overview, maximal security and sufficiently sterile conditions for treatment. During the treatment, by drilling the grinding surface of tooth, the old root filling and the tissues and nerves of root canals are dislocated with files and canals are enlarged. In case the tooth was infected, disinfecting substance (calcium-hydrochloride) is injected in canals. In such case, treatment may be carried on approximately a week later and tooth may be endowed with root filling (using gutta-percha point and sealer). Shall the tooth and bone-tissue around tooth not infected the canals may be filled in one meeting after expansion. Expansion and precise filling of canals is a time consuming process. Normally, one hour is required in each meeting.

Temporary filling:

Temporary filling is needed between two meetings to impede the further infection of tooth from mouth cavity.

Complaints:

  1. During intervention:

Root canal treatment is a painless intervention under local anaesthesia. In case of very inflamed tissues, striking feeling or sometimes pain may occur.

Frictional sound and raspy feeling in bone may cause discomfort upon enlarging canals and utilising hand operated or mechanical files

  1. During root canal treatment:

Location of injection may be sensitive for a few days.

In case of chiefly mortified teeth, one may encounter blunt and tensile pain subsequent to dislocation of mortified tissue debris (nerves and veins) from canals. In such cases, a significant amount of bacteria and mortified tissue debris may reach root apex that causes inflammation in the bone. Pain occurring for 1-2 days may be eliminated by using pain-killer. In case the protective reaction is of great significance, namely it ceases only for a few minutes after receiving pain-killer, the tooth needs another session of cleansing. Tensile pain is caused by phlegm discharged during inflammation.

Occlusion sensitivity

  1. Fulgurate pain and pain emitting to temple and mandible may be due to the involvement of nerve fibres and it may last for some days or weeks with decreasing intensity. It completely ceases after the regeneration of nerves.
  2. Subsequent to treatment, the process may flare up, therefore tooth free of complaints may be aching and inflammation may reach soft tissues and face may swell. Symptoms slowly cease after the cleansing and desinfection of canals.
  3. In case of events combined with swelling and suppuration, spontaneous pain or occlusional sensitivity occur rather frequently between treatments. These complaints cease within a few days or slowly wear on. In such cases, antichloristic laser treatment is suggested.
  4. Teeth that are infected and untreated for years cause pain of unsure nature for weeks or even months subsequent to treatment; the process may flare up and facial swelling may occur
  5. Part of tooth under root canal treatment sometimes may be broken off.
  6. Temporary filling may fall off. Please, consult your dentist.

After root filling:

1. Location of injection may be sensitive for a few days.

2. Fulgurate pain and pain emitting to temple and mandible may be due to the involvement of nerve fibres and it may last for some days or weeks with decreasing intensity. During the regeneration of nerves (3-6 months), unsafe slight pain may occur.

3. Occlusional sensitivity.

4. Facial swelling.

5. In rare cases, inflammatory focal may occur around the apex may be formulated years after the treatment.

Complications:

1. If the swelling or the local protective immune reaction of body is of significance, the face may be swollen. Swelling is caused by the fact that the inflame and the protective reaction may reach the bone or soft tissue around bone. In case pus is discharged, scission on mucosa shall be performed to clear away pus.

2. In case the canal may not be expanded (due to tartar and clogged canal section), root canal treatment is partly successful. The future of tooth individually varies (keeping, resection or extraction of tooth). It is decided by joint resolution of patient and dentist.

3. File is blocked in narrow canal, expansion file seized and broken in canal and root filling may be partly performed. Due to breaking of file, one shall consider resection of root.

Warranty:

Warranty may be claimed in case the root filling has been performed incorrectly (it is not wall resistant and it does not reach apex) or the symptoms are due to a hidden therefore untreated channel. Warranty solely covers the performing of root filling.

Warranty does not cover complication derived from the expansion of inflammatory processes or the deficiency of protective system of body.

Final treatment:

Subsequent to root filling, the restoration of coronal part of tooth is carried out by utilising the so-called onlays or, in case of severe destruction (tooth pulp loss), it is performed by applying the combination of post and crown.

Facts about root canal tretament, that used to be the most feared dental treatment but lately it is completely painless.

  1. Did you know that root canal treatment with appropriate anesthesia is completely painless?
  2. Did you know that after the root canal treatment the tooth does not die, as it was only the internal part of the tooth treated by the dentist.
  3. Did you know that after a root canal treatment the root canal is cleaned and it is not left empty, but treated with root filling.

 

 

 

Something extra in root canal tretament

Microscopic root canal treatment can only be achieved only at a very few dental clinic as it is a brand new special procedure. At our clinic it is available.

In conventional root canal treatment dentists can not see the roots, just feel it and try to remove the infected tissue and close the root canal. This can be effective, depending on the experience of your dentist. The microscope makes everything much more apparent. With the help of microscopes side root channels can also be found. If a microscope is used during root canal treatments then the dentist sees and controlls what she/he does!

Thanks to the special instruments used in addition to microscopes (ultrasonic dissection instrumentation, micro-needles, negative-pressure cleaning systems etc) even the smallest bacterially infected tissues can also be detected and removed! The success of treatment is greatly increased, often unnecessary tooth extractions can ba avoided if microscopes are used. Even the most hopeless teeth can be saved and extractions are not needed.

The treatment:

1., Multi-directional X-rays or, where appropriate, 3D scans can be prepared to map root canals.

2., A special thin needle is used as an anesthetic making treatment painless.

3., A special isolation system (rubber dam) is used which prevents bacterias from entering the tooth and prevents disinfectant liquids and tiny devices from entering the mouth.

4., The microscope is used to clean and disinfect the root channels.

5., With a special electric meter the length of roots is accuretaly measured.

6., Finally a special warm liquid gutta-percha filling material (B-System,Obtura III, GuttaCore) is used to close the root canal system.

What is the cost of microscopic root canat treatment?

The microscopic root canal treatment is expensive. This is because it needs special instrumentation, special expertise and we have to take into consideration the amount of time spent on a tooth. Treatment might take up to several hours per tooth. However, an extracted tooth can be replaced by a bridge, or even dental implants that can be much more expensive. The biological price of loss of healthy tooth substance can not be expressed in terms of money.

The application of dental implants works perfectly safely but if there is a way it is advised to preserve your own natural teeth.