ROOT CANAL TREATMENT OR ENDODONTIC THERAPY

ROOT CANAL TREATMENT OR ENDODONTIC THERAPY

•       INTRODUCTION

•       WHAT IS ROOT CANAL TREATMENT OR ENDODONTIC THERAPY?

•       BENEFITS OF ENDODONTIC THERAPY

•       STEPS INVOLVED IN ENDODONTIC TREATMENT

•       INDICATIONS FOR TREATMENT

•       CONTRAINDICATIONS FOR TREATMENT

•       WHO PERFORMS ENDODONTIC THERAPY

•       SCOPE OF ENDODONTICS

•       CONCLUSION

INTRODUCTION

                Instead of the choice of extraction when toothache arises, a better choice of treating the teeth like every other part of the human body is the basic and proper decision to make. Will you cut off your arm because of shoulder pain?...CERTAINLY NO.

Endodontics is the branch of dentistry which is concerned with the morphology, physiology and pathology of the human pulp and peri radicular tissues.

    WHAT IS  ROOT CANAL TREATMENT OR ENDODONTIC THERAPY?

                Endodontic or Root Canal Therapy/treatment is a procedure performed on a symptomatic tooth, to remove the pulp tissues, clean and treat the canal(s) and finally fill it with an inert material.

                Endodontics involves the diagnosis and treatment of inflamed and damaged pulps and their sequelae to maintain function and structure of the restored tooth.

               

                Knowledge of the biology of the pulp is essential for the development  of a rational treatment plan because lesions that do not arise from the pulp (perio-endo lesions) may be mistaken for those that are arising from the pulp.

•       RATIONALE OF ENDODONTIC THERAPY

                Endodontic pathology is mainly caused by injury to the tooth (physical, chemical or bacterial). Such injury can results in reversible or irreversible changes in the pulp and periradicular tissues. These resultant changes depend on the intensity, duration, pathogenicity of the stimulus and the host defense mechanism.

•       BENEFITS OF ENDODONTIC THERAPY

                Endodontic therapy saves teeth that would otherwise be extracted. Although the pulp is removed, the treated tooth remains alive, nourished, surrounded and supported by the periodontium. There is no real substitute for natural tooth which is more efficient in chewing and biting.

  STEPS INVOLVED IN ROOT CANAL TREATMENT OR ENDODONTIC TREATMENT

The endodontic triad

•       Create access to the canal(s)

•       Clean and shape the canal(s)

•       Treat and seal the canal(s)

                Endodontic therapy removes infected or damaged pulp tissues. After removal, the pulp chamber and root canals are cleaned, sterilized, filled and sealed with a crown.

INDICATIONS FOR FOR ROOT CANAL TREATMENT

Many factors appear to determine the need for root canal treatment but decision depends mainly from the clinician’s jugdement after proper diagnosis. These factors include:

a. Accessibility of apical foramen.

b. Restorability of the involved tooth.

c. Strategic importance of the involved tooth.

d. General cooperation of the patient.

Absolute Indications OF ROOTH CANAL TREATMENT

•       pulp involvement due to caries

•       irreversible pulpitis

•       pulpal necrosis

•       apical periodontitis

•       Trauma

•       Fractures

•       Other sequelae of pulpal insults.

•        

•       Elective endodontic.

                This is done in a cracked or heavily restored tooth, to prevent premature loss of cusp during their restoration (usually crown preparation) and eliminate fear of pulp exposure. This allows a more predictable and successful restorative dentistry

•       Devitalization of Tooth:

                In patients with attruded teeth, rampant caries or recurrent decay and smooth surface defects, done to alleviate the discomfort and pain of such patients. Usually done in children when there is difficulty in achieving cooperation. Example in Special need children.

•       CONTRAINDICATIONS FOR TREATMENT

                Endodontic treatment is contraindicated in the following persons and scenarios.

–      Non-restorable teeth

–      Tooth in which instrumentation is not possible

–      Tooth with poor accessibility

–      Untreatable root resorption

–      Vertical tooth fracture

–      Non-strategic teeth

–      Patient factors

•       WHO PERFORMS ENDODONTIC THERAPY?

•       Dentists

                All dentists receive some training in endodontic therapy in dental school.

•       Endodontists

                These are specialists who limit their practices to root canal procedures.

•       SCOPE OF ENDODONTICS

                The practice of endodontics have undergone tremendous improvement in recent times especially in choice of filling materials and with advancements in implantology, modern technologies etc.

                The use of amalgam as a filling agent in the past decades have been replaced by several other filling materials.

                Products like:

•       Vivadents.

•       Optrafills

•       Amalgomas

•       compomers

•       And several other modified cements.

                Improved technologies have also been employed in the field of endodontics that aids in achieving desirable results in a short period of time. Such products includes

•       The use of Computer Assisted Devices (CAD) and 3-Dimensional Laser devices in diagnosis and filling of root canals.

•       Implants designed to activate growth of connective tissues, provide functional transfer of occlusal forces and support of the peri-implant bone and overlying soft tissues. Example:

                -Macro-designed implant (tooth analog)

                -Micro-designed implant (FRIALIT CELLplus)

                -Nano-designed implant (FRIADENT CELLplus)

                  -FRIALIT Cortical Drill.

•       Other new products like Colgate Sensitive Pro-Relief Desensitising Polishing Paste  relieves tactile-induced dentine hypersensitivity and it can easily remove stains when used as polishing agent.

  
-What Does An Endodontist Do?

                The endodontist undergoes further postgraduate trainings in addition to dental school and/or have been certified by a Board of Endodontics after passing series of examinations.

                An Endodontist does the following:

•       Diagnoses and treats pain

•       Treats traumatic injuries

•       Performs orthodontic extrusion

•       Salvages avulsed tooth

•       Performs intentional replantation

•       Bleaches discoloured teeth (endodontically)

•       Performs surgery

                - apicectomy (root-end resection)

                -hemisection (the surgical separation of a mandibular molar tooth).

•       Places post and/or core build-ups

•       Places endodontic implants

•       Treats fractures

                -horizontal fractures

                -middle third fractures

•       Places intraradicular implants

•       Performs endodontic retreatments

•       Performs Guided Tissue Regeneration (GTR)

•       KEEP SMILING, YOU WONT LOOSE YOUR TOOTH. Thanks to your Endodontist.

     CONCLUSION

                For a predictable and successful endodontic therapy, careful patient selection, proper diagnosis, a good treatment planning and proper skillful use of the available modern technologies are important.

                Refresher courses are advocated for endodontists, for them to remain relevant in the fast changing endodontic environment. And also to help them get acquainted with the trend, knowledge and skills required to offer good treatment options to their patients.

                Every effort should be made (even in listed contraindications to RCT) to conserve the tooth in the mouth. Because as the old dental adage says: nothing serves better than the natural teeth

•       REFERENCES

•       Textbook of Endodontics by Dabas U. And Dbas V.K

•       Textbook of Endodontics by Garg N. And Garg A.

•       Principles and practice of Endodontics by Walton and Mahmoud

•       www.wikipedia.com/endodontics.126hh

                THANK YOU FOR LISTENING

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