Root canal treatment instead of tooth extraction
The tooth has to come out? In most cases this does not have to be the case, because a root canal treatment can even save a very damaged tooth!
This is how we save your teeth with a root canal treatment:
- Removal of the dental nerve
- Preparation of the root canals
- Closure of the tooth roots
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root canal treatment
When is a root canal treatment necessary?
Eliminate inflammation, relieve pain, save teeth
The pulp is located inside a healthy tooth. In deep caries or when a large piece of the tooth breaks off, bacteria can enter the pulp. In rare cases, the pulp can also be infected via a deep gum pocket. This can lead to a very painful and tissue destroying inflammation. The further penetration of the pathogens and the degradation products of the dying pulp then cause a defensive reaction of the body around the root apex. Inflammation of the tooth root can exist painlessly and unnoticed over a longer period of time. This inflammation, however, is an interference field in the body and can also trigger symptoms in other parts of the body. The focus of inflammation can change into an acute state at any time. This manifests itself among other things in bite problems or purulent abscesses with a swelling in the area of the root tip. The treatment begins with an x-ray. The x-ray not only shows the extent of caries or inflammation at the root tip, but also provides information about the anatomy and the preliminary preparation length. In a root canal treatment, the greatest possible freedom from bacteria in the root canal system is essential. For the production of a sterile working field, we therefore work with a cofferdam if necessary. The coffer dam is a rubber that is stretched over the tooth to protect the inside of the tooth against bacteria from the oral cavity. The crown of the tooth provides access to the root canal system. This step should be done very carefully with magnifying glasses or a surgical microscope. This careful work preserves the essential anatomical structures and does not weaken the tooth unnecessarily. The side canals in the root canal are cleaned with ultrasound. In addition, disinfectant rinsing solutions are used to remove and rinse out organic residues in the root canal.
In the next treatment session, the root canal system is usually filled definitively and impermeably. Adhesive filling therapy is intended to prevent bacteria from entering the root canal at a later stage, the so-called “microleakage”. In order to prevent overfilling or underfilling of the root canals, the canal lengths are measured electronically. The canal is filled with the natural material gutta-percha. It is also possible to glue in a thermoplastic polyester, a so-called “monoblock”. After the treatment, two final radiographs must usually be taken to check the length and tightness of the root canal filling. Root tip resection (WSR) – last rescue of the tooth before tooth extractionA root tip resection is often the last possibility to preserve a tooth. Root apex resection may be necessary if inflammation does not completely heal despite careful root canal treatment. The access to the root tip can be made via the tooth crown (orthograd) or laterally via the jawbone (retrograde). During the treatment, a few millimetres of the root apex and inflamed tissue are removed. The cleaned root canal opening is then filled and closed. Duration of a root canal treatmentA root canal system is very complex; the structures are not always immediately visible. A gentle root canal treatment can therefore take several sessions, but usually two to four hours are sufficient. The treatment method is more gentle and effective today, so that the effort is clearly worthwhile in comparison to the benefit. Prospects of success of a root canal treatmentRoot canal treated teeth do not show any temperature sensation. The sense of touch, however, still exists because the nerves in the periodontium remain intact. Modern root canal treatment offers very good chances of keeping a diseased tooth healthy again and free of inflammation in the long term. The canals are seldom so branched that treatment is not possible. The root canal treatment weakens the tooth somewhat and can also turn grey. Root-treated teeth should therefore be fitted with a crown or partial crown to protect the tooth from breaking apart or re-infection. The bone surrounding the root of the tooth needs about six to twelve months to regenerate after the treatment. The German Society for Dental Preservation (Deutsche Gesellschaft für Zahnerhaltung) states a success rate of up to 95 percent for root canal treatment.
A root-treated and ceramic treated tooth can perform its full service in the mouth for a lifetime. Regular checks and regular professional tooth cleaning are important! Alternatives to root canal treatmentThe only alternative to root canal treatment is to pull the tooth. This gap must then be replaced by a bridge or an implant.