Root canal (endodontic) treatment

Root canal treatment (endodontic treatment) is performed when bacteria or other microorganisms enter the root canals of a tooth due to dental decay, various dental traumas, cracks in the teeth, or other reasons. Once inside the root canals, these microorganisms infect the tooth nerve and damage the dental pulp (soft tissues). When the pulp is damaged, it leads to the development of pulpitis, during which the blood vessels and nerves of the tooth die. If left untreated, pulpitis can progress to a more serious condition called periodontitis, which is a disease affecting the teeth and gums, where bacteria that have entered through the root canals can damage the gums or jawbone.

Pulpitis is treated by removing the damaged (decayed) tissues and, if necessary, removing the affected pulp if it cannot be preserved. Then, the canals are mechanically cleaned, treated with chemical solutions, and filled with a sealing material.

The most common cause of pulpitis is untreated tooth decay (caries) that allows bacteria to reach the dental pulp through the damaged tissues. However, pulpitis can also develop due to other reasons such as bruxism (teeth grinding), various dental traumas, tooth fractures, and other factors.

Root canal treatment is performed during one or multiple visits. Prior to the treatment, the patient undergoes radiographic diagnostics to accurately assess the condition of the root canals.
Radiographic diagnostics are performed throughout the entire endodontic treatment to ensure that the root canals are fully cleaned and sealed.

The treated tooth is numbed using local anesthetics and isolated with a rubber dam. The root canals are then thoroughly cleaned mechanically and treated with chemical substances. Afterwards, the canals are reshaped and filled with a filling material. Once the canals are filled, the tooth crown is restored with a dental filling.

If the root canal is infected, during the first visit, a medicated calcium paste is often placed in the canal, and a temporary filling is placed on the tooth crown until the next visit.

If root canals are left untreated, the microorganisms present in the pulp can penetrate the apex of the root and cause inflammation in the surrounding tissues. This can lead to gingivitis and later periodontitis, as well as bone resorption around the root and other complications.

Endodontic retreatment follows a similar procedure to the initial root canal treatment. It is typically performed when the initial endodontic treatment was done improperly or when there is a secondary infection due to incomplete cleaning and filling of the root canals.

During endodontic retreatment, the old filling material is removed from the root canals, and the canals are thoroughly cleaned, shaped, and filled with new filling material. The tooth crown is restored with a filling or a dental crown.