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Endodontic Dental Treatment

Endodontics is the area of dentistry dealing with root canal therapy, including treatment of root canal infection, dental pulp removal and treatment of pulp decay, removal of infected dentin, optimal root canal shaping, high-quality airtight sealing of root canals along their length.

A clinical case below (Photos 1-3) demonstrates endodontic treatment of a mobile tooth:
 

   

A woman, 55, complained about the mobility of a front tooth in the upper jaw. Previously, the dental canal in this tooth had been treated and, after a failed endodontic treatment, the root tip resection was performed. By the time the patient approached our Clinic, the tooth mobility was quite noticeable. However, the doctor decided to preserve the tooth by removing the tooth root (1) and the affected area (2) that caused the bone tissue destruction
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Using a microscope, the doctor applied the periapical matrix treatment method and a MTA filling (Mineral trioxide aggregate that is a biocompatible material). Due to modern endodontic treatment methods, we succeeded in preserving the tooth. MTA apical plug (3)
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Two weeks following the treatment the tooth mobility disappeared. A follow up X-ray was taken 5 months later and confirmed full recovery. Bone tissue was completely restored (4)

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Dentistry as we want it to be

At the current stage of development of dentistry, it is a common understanding that if a dental treatment was determined solely by visible issues, many details would be overlooked that eventually could affect the treatment outcome.

The modern dental treatment is impossible without a microscope. Magnification allows to identify and remove fragments of dental instruments, seal root perforations, effectively unseal the hard-to-reach root canals and treat them, identify other hidden canals or cracks and other issues.

       

Dental microscope
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Thanks to dental microscopes used at our Clinic, not only do we ensure high quality dental treatments for common issues, but we also achieve good results in complicated cases where little could be done without a microscope magnification. That is why we can positively say that the use of a microscope in dental treatments has clear benefits and provides for a higher quality dental care.


Endodontic Treatment Process
Anatomy of root canals varies and depends on the individual.

The reasons for endodontic treatment could be one of the following:

Pulpitis
is an inflammation of the tooth pulp, usually due to a complication of caries. It could go unnoticed without symptoms, for instance, under an old, low-quality filling or crown. Pulpitis could also cause pain of different nature and intensity.
Pulpitis could be usually treated in one visit.

Periodontitis
is a complication of pulpitis when the inflammatory process affects the tissues outside the tooth (periodontium). It could occur in different ways, it could hurt or go symptomless, even if tooth decay is extensive. An X-ray may show an image of what is sometimes mistakenly called a cyst. However, in most cases it is a wrong assumption, because a cyst cannot be diagnosed with an X-ray image. Generally, periodontitis could be cured provided all root canals are thoroughly cleaned.

In some cases, periodontitis could develop due to errors made during a root canal treatment, dental malpractice, because some root canals were overlooked or improperly obturated, or due to the lack of a proper antiseptic treatment. It could also result from perforations or instrument fragments left in canals.

Depending on the severity of a situation, treatment of periodontitis could be completed in one visit, two and more visits.

This clinical case (Photos 1-3) shows rehabilitation of a tooth with a fragment of an instrument removed from the root tip:
 

   

A fragment of an instrument was identified in a maxillary canine that was treated in another clinic. An X-ray showed that the fragment was located a few millimeters over the tooth root apex. The tooth did not hurt; however, it was decided that the fragment should be removed since it would inevitably corrode and a toothache could develop at any time. Spiral-shaped fragments of the intracanal instrument (1), the tip of the tooth root (2)
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The fragment of an instrument was removed. X-ray of the tooth before the canal has been sealed. The fragment was entirely removed (3)
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After the fragments were removed using the dental microscope, the root canal was sealed and indirect dental restoration performed (inlay and crown). Root canal after filling (4)

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Once the diagnosis is made and a treatment plan is agreed with a client, the treatment is performed under a general anesthesia. The tooth is isolated with a rubber dam (this is essential for effective endodontic treatment).
 

       

Tooth isolated with a rubber dam
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All dental root canals get thoroughly cleaned out, disinfected and filled using the method of liquid gutta-percha volume condensation.

Tooth filling methods that could cause tooth colour change are not applied.

Since the main goal of endodontic treatment is the preservation of a tooth for possible restoration or covering with a dental crown, it is essential that all necessary steps are taken to ensure its life cycle is extended. The Clinic of Aesthetic Dentistry offers endodontic treatments of a high standard, including treatments in complicated cases. For more details, please call us on (044) 230-83-88.

 

 

 

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