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A dental pulp is located in the canal system of a tooth. Nutrient function of the pulp is accomplished through a complex vascular system, and its rich innervation is responsible for the tooth being reactive to the stimuli.
The main cause of dental pulp diseases are bacteria. There are a few different ways, by which they get to the dental pulp, causing its inflammation. It’s most commonly happening through caries. However, dental pulp can also suffer as a result of an injury that bares it or even an injury that doesn’t bare it, but wasn’t treated early enough.
First symptoms of pulp infection can be as follows: sudden idiopathic pain symptoms, heightened sensitivity for cold and hot, discomfort felt while touching or chewing. Sometimes the pulp infection can be an asymptomatic and chronic disease and the only indication of it is frequently feeling a mild discomfort from the tooth or the surrounding tissue, throbbing feeling, radiation, presence of a fistula (a small, raised lesion filled with pus, that appears on the gums) or – visible on the X-ray photograph – apical change, spotted during a routine control visit.
The purpose of an endodontic treatment is elimination of bacteria from the root canals, mechanical and chemical handling and tight filling of the whole system.
It is also possible, that an endodontically treated tooth requires re-treatment. The procedure in such case consists of removal of the previously used materials from the tooth canals, their disinfecting, handling and refilling.
If the standard endodontic procedure has no anticipated effect, a microsurgical procedure might be necessary. Using the right instruments and microscopic augmentation guarantees conducting of the procedure in a highly precise and easy on the bone and root tissue way.
Root canal treatment is also conducted on children, both on the deciduous and on the permanent teeth. The way and scope of the procedure should be adjusted to the development stage of the treated tooth’s root system, its prognosis and a possibility of cooperation with a little patient.
A root canal treatment should be preceded by a radiological diagnosis. Before starting the treatment, during it and after it is done, the doctor takes intraoral photos, and in more complex cases takes a cone beam computed tomography.
After making an adequate way of access to the tooth crown, the pulp is removed with adequate instruments. The treatment is conducted under anesthesia, cofferdam insulation and often at magnification by a dental microscope.
The canals are cleaned, enlarged and rinsed with specially picked agents of an adequate concentration and in a particular order. Next, depending on the case, the doctor picks the right material and method of filling the canal.
The duration of an endodontic treatment is subjected to many factors. In case the complete treatment is not possible during one visit, the procedure ends with applying a temporary filling.
After the root canal treatment is finished, the gap from the side of the crown must be tightly sealed in order to prevent a reinfection of the root canal. After the Endodontic treatment the teeth are more prone to damage and fractures, so we often use inserts cemented in the root for their reconstruction and intermediate fillings reconstructing the crown of the tooth – such as prosthetic overlays and crowns.
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