Endodontics is the field concerned with the diagnosis, prevention and treatment of diseases of the pulp, the interior of the tooth. Endodontic treatment is needed when inflammation or infection is present inside the crown and/or root of the tooth. The most common causes are decay and trauma.
Endodontics – why thorough treatment matters
The pulp chamber and root canals form a complex neurovascular system. Decay, trauma or other causes can irreversibly damage this system, and the tooth begins to die. This may happen with pain, but most often the patient has no symptoms at all. In that case a dead tooth is discovered incidentally at a clinical or X-ray examination.
When the tissue inside a tooth dies, the remaining necrotic organic material becomes a breeding ground for bacteria. Bacterial growth triggers an inflammatory response that creates a bone cavity at the root tips. This clinical picture is called a granuloma.
Root canal treatment – what is the goal?
The main goal of root canal treatment is the removal of inflamed or necrotic tissue from the entire root canal system. Residual tissue and bacteria reduce the likelihood of success, so problems may persist or reappear later despite treatment. When treatment is carried out precisely and thoroughly, the bone cavity closes within a year in most cases.
Primary root canal treatment is performed when a tooth has not been treated before and the roots are cleaned for the first time. Our success rate is high (over 90%), and the treatment is usually not complicated.
In root canal retreatment, the tooth has already been treated in the past but the inflammation persists. This type of therapy is more complex and the chance of success slightly lower (over 80%). Less often, the inflammation in the bone persists despite well-performed treatment. In that case an apicoectomy is performed – a minor surgical procedure in which the infected root tip is removed together with the surrounding inflamed tissue.
To achieve the best possible results we use all modern equipment, including a microscope, rotary canal shaping systems, a laser and ultrasound.
Planning the final restoration in root canal treatment
The purpose of root canal treatment is to eliminate the inflammation caused by infection of the root canal system. Afterwards, the tooth’s function and aesthetics are restored with prosthetic procedures ranging from simple composite fillings to larger all-ceramic restorations. A key step is assessing whether treatment makes sense. Before therapy starts, the final functional and aesthetic rehabilitation has to be planned. If we judge that the tooth could not be definitively restored after root canal treatment, the therapy is not worthwhile.
A common complication after successful root canal treatment is a crack or fracture of the tooth or its crown. Teeth that need root canal cleaning are already more fragile because of the underlying cause (decay, trauma …), and proper endodontic shaping and cleaning weakens them further. Appropriate prosthetic restoration after root canal treatment is an important step of the overall treatment, as it greatly reduces the risk of complications that could lead to tooth loss.
Endodontics – treatment with specialist equipment
Microscope
Working with an operating microscope provides high magnification and better illumination. It makes it easier to locate additional canals in the root system and to remove broken instruments and remnants of failed fillings, thereby increasing the success of treatment.
Ultrasound and laser
Combined with the operating microscope, endodontic ultrasound is used to remove remnants of infected tissue, old root fillings and calcifications, and to further irrigate the canal for thorough disinfection.
A hard-tissue laser enables additional activation of disinfectant irrigation in the root canal system.
How much does root canal treatment cost?
Root canal treatment with specialist equipment costs from €350. The price depends on the complexity of treatment (first treatment or retreatment, the anatomy of the tooth, …).
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