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Endodontic treatment

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Dr. Blagoy Nikolov/ 24.08.2023 

Root canal treatment is one of the most common procedures, done by dental professionals. It is indicated in cases of pulpitis, apical periodontitis and in some instances, tooth trauma.

 

What does endodontic treatment mean?

Endodontic treatment, also called root canal treatment, is a procedure aimed at treating the innermost part of the tooth, called pulp. The pulp consist of the tooth nerve fibers, blood vessels and connective tissue. When pulp tissue gets damaged or infected due to profound caries, tooth cracks, trauma, etc., it can provoke severe pain, inflammation and even abscess formation.

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The endodontic treatment consists of removing the damaged and infected pulp tissue and copious irrigation, aiming to disinfect the root canal, combined with shaping of the canal to make a specific form and tapper. After that, the root canal gets filled with a hermetic filling of biocompatible material to protect it from future infection. 

 

After root canals get filled up, the tooth usually gets restored by a crown, which is needed to protect the residual tooth tissue from fracturing, of which they are more susceptible after endo treatment. All those procedures are aimed at preserving the natural teeth and avoiding extraction.

 

With the advances in medicine and the development of effective anesthetics, root canal treatments became painless with a high success rate. This allows us to save more teeth from extraction, thus retaining natural function.

What does endodontic treatment consist of?

The endodontic treatment is a technically complex procedure, which consists of several stages:

1. Diagnosis: the dental professional makes a profound check-up, and assigns X-rays to determine the amount of infection and the degree of the inflammation.

2. Anesthesia: local anesthesia in the area of the tooth provides minimal discomfort and with no pain.

3. Endodontic access: because the pulp is in the innermost part of the tooth, surrounded from all sides bar hard tooth tissue, an opening is needed to reach the pulp tissue.

4. Shaping and cleaning of the root canal: After access to the damaged pulp tissue is obtained, it is removed with specially made instruments and disinfecting solutions. After the removal of the soft tissues from the tooth, the root canal walls are made to a specific form, needed for optimal root canal filling.

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Рентгенова снимка на зъб с пулпит
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Ендодонтски достъп
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NiTi машинни инструменти

5. Irrigation: after the canals have been shapened, there is a copious washing with various sollutions aimed at killing all microbes remaining in the root canal system.

 

6. Root canal obturation: after drying the canal, it gets filled. For this we used specially made gutta-percha points. In order to obtain hermetic sealing, the space beteam the gutta-percha points and the root canal wall is filled with a special material, called sealer.

7. Tooth restoratiom: after filling the root canal, the crown of the tooth gets restored. This can be done with a filling, but is better to get a crown. Sometimes, when the tooth is severly damaged, post may be needed.

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Ендоаспиратор

5. Иригация: след като каналите бъдат оформени, следва обилно промиване с различни препарати, които целят унищожаване на всички микроби, останали в системата на кореновите канали.

система за промивка на коренови канали

 

6. Обтуриране: след подсушаване на каналите се пристъпва към запълването им. Понастоящем за целта се използват специално разработени щифтове от гутаперка, която представлява инертен материал. За да бъде постигнат херметизъм, пространството между щифта и стената на канала се уплътнява със специален материал, наречен силър.

силър за коренови канали

 

7. Възстановяване на зъба: след успешното запълване на каналите, се пристъпва към възстановяване на анатомичната форма на зъба. Това може да бъде направено с обтурация (пломба), но за предпочитане с обвивна коронка. Понякога, при силно разрушени зъби, може да се наложи поставянето на щифт.

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Силър за обтурация на коренови канали
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Снимка на зъб със завършено кореново лечение
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