What is done with root canal treatment??
The essentials in brief:
- For a root canal treatment, the dentist has to open the tooth and clean and disinfect the canals.
- If the inflammation returns, the treatment can be repeated. This so-called revision is complex, the success rate drops.
- A last treatment option is a surgical intervention: during root tip resection, the dentist removes the root tip and inflamed tissue through the bone.
How does a root canal treatment work??
Each tooth has multiple roots and fine, branched channels. They contain the pulp, i.e. blood vessels and nerve tissue. Inflammation there usually causes a throbbing toothache (graphic, image 1). As a rule, several treatment steps are necessary, usually under local anesthesia: the dentist opens the tooth and cleanses and disinfects inflamed or dead tissue (Fig. 2 and 3) of the nerve cavity and the root canals. Then he fills the canals and closes the tooth (image 4 and 5).
What happens if the treatment fails?
Because of the very finely branched root canals, root canal treatment is a complicated procedure that does not always work. In some cases, a new treatment is necessary, for example if canals were not adequately or not cleaned at all in the first session, or if bacteria had penetrated the root canal system through the filling. Then one speaks of revision treatment. It is very similar to the initial treatment, but is usually more time-consuming. The old filling material has to be taken out and it may be necessary to fight the bacteria in the channels with a drug. The success rate for revision is lower than for initial treatment.
What is a root tip resection?
If revision treatment was unsuccessful, root tip resection remains the last option to save the tooth. This surgical intervention is indicated if the root canal system cannot be treated adequately, if the root is so damaged that conservative therapy is not sufficient, or if there is a root fracture or root resorption. The dentist has to loosen the gums in the area of the root tip and expose a part of the bone. Then the root tip and other inflamed or infected tissue are removed. Then the inside of the root must be cleaned from the tip and also filled from there. After the procedure, the bone around the root end has to heal again.
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