Endodontics is a speciality of odontology which deals with prevention, diagnostics and treatment of the soft tissue inside the teeth, which contains nerves and blood vessels, and which is responsible for the tooth development.
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Endodontics are treatments that consist in eliminating the damaged tissues from inside the tooth and replacing them with a substance that avoids the bacterial permanence and growth.
Once the endodontic treatment is done, the tooth must be restored with a filling, a reconstruction or a crown (depending on the remaining tooth structure after the treatment).
When the cavities have destroyed most of the tooth, a simple filling would leave it too weak and could break during chewing. It is therefore necessary to reinforce it with a support (post or bolt) and it may also be necessary to protect it with a cover or crown.
Generally speaking, most endodontic treatments are done in one single session, though depending on the difficulty of the case, more sessions may be required.
- Due to cavities that evolve inside the tooth until they reach the nerve, damaging it irreversibly.
- When the tooth is too sensitive to cold, heat, sweets or chewing.
- When it starts gradually changing its colour.
- When it hurts spontaneously or constantly.
- When pus has broken through the bone and the gum.
- Or, even without symptoms, when the root lesion appears under radiographic dental control as a focus of infection.
Even though the treatment may be a success for the endodontics specialist, a low number of cases may fail. Once the dentist has diagnosed the failure of an endodontic treatment, it’s not always necessary to extract the tooth; a new root canal treatment (reendodontics), or surgical treatment (apicoectomy) can be performed.
Root canal treatments are not painful. It is possible that some discomfort appears after the treatment, that last for about 8 to 12 days and that can be alleviated with analgesics and/or antiinflammatory medication.
The incorporation of mechanical tools has led to one of the greatest advances in the specialisation of endodontics.
These systems are composed of several files of different calibre, which can be mounted on a microengine, similar to those used to treat cavities.
Generally speaking, we use four to six rotary files of different calibres for the endodontic treatments, following a specific series.
Contrary to manual files, rotatory or mechanical files achieve a superior cleansing and debridement of root canals, and in a much more effective manner. As for the curved canals, the use of these limes mean that we are less conservative when it comes to cleaning them because, being more flexible, we cause very little change of the root canals. Furthermore, the treatment time is drastically reduced. Thus, the endodontic treatment becomes less cumbersome for the patient.
Another quality of these systems is that they disinfect the root canals more effectively, since the vibration of the files helps the distribution and activation of the liquid that is used to irrigate and disinfect the tooth. It is important to note that the use of rotary files does not completely substitute the conventional manual files. We need to use those first to clear the way for the mechanical files.
In the same way, it may be necessary to use conventional files throughout the treatment to access narrower zones and to make sure that we are not clogging the canal with debris from the filing.
Ultimately, using the mechanised endodontics systems will reduce the treatment time and achieve better disinfection and cleansing of the root canals of the tooth, which in turn leads to better prognostic and the possibility of preserving our own teeth for a longer time.
SPECIALISTS IN ENDODONTICS