To understand the concept of Root canal Treatment, the normal anatomy of the tooth would have to be understood. The tooth that we see in our mouth is held in the jawbone by its roots. Though the tooth is one hard structure that can break nuts and crush bones, the heart of the tooth is a soft structure encased in hallow.
As seen in the picture, the tooth is secured in the bone with supporting ligaments which provide sensation and cushioning to the tooth where as the nerve and blood vessels enter the inside of the tooth through a small hole at the tip of the root and travel through a channel called root canal up to the crown portion of the tooth. This soft tissue is called the Pulp. Any cavity or the fracture line of tooth that reaches the pulp or commonly called nerve, leads to inflammation and infection thus leading to a condition called pulp hyperaemia, an indication for Root Canal Treatment.
The condition is sensed by the patient due to
· Increased sensitivity to hot and cold
· A wide cavity
· A broken tooth.
It is diagnosed by the dentist with the help of clinical appearance of the cavity, dental radiographs or x-rays, electronic pulp tester and hot and cold stimulation. Once it is diagnosed, the patient is scheduled for the root canal treatment under the cover of antibiotics.
An infected pulp due to a deep cavity or a crack can’t cure itself, so the process of decomposition starts. There is pus formation in the tooth that builds up in the root tip area in the form of abscess thereby causing bone destruction and pain. In some cases of a large open cavity, the decomposition of the tooth keeps going on slowly and the pus thus formed keeps escaping causing little discomfort to the patient and the tooth withers slowly leaving the roots behind. Such open teeth or canals are a direct communication between the internal system of the body to the external oral environment which houses a great number of germs.
Root canal treatment involves the removal of the central soft tissue or pulp or the commonly called nerve. A straight line access is made by drilling in the biting surface, no matter where the cavity is, so as to clean the canals to a smooth finish
The Root Canals after cleaning are restored or filled with a plastic like material called Gutta Percha in the form of cones or preferably in a warm type which flows into all the spaces of the canal which are unreachable otherwise. The RCT technique used in Align Orthodontics is the newest Crown-Down tech. followed by a root filling with resin based sealer(AH plus) and heated gutta percha (Themafil). It is an inert and non-toxic material.
Tooth is then restored to its normal position with composite or core build up material and allowed to heal for sometime before capping.
Post and Core is done to assist the filling if the tooth is grossly damaged & is weak at the neck.
A metal or fiber glass post is inserted in the prepared Root Canal to gain strength from the tooth Root. It is then cemented and the filling is done. The tooth is later prepared for the crown/cap.
Since the tooth becomes brittle after it turns non-vital due to cavity or any other reason, the root canal treatment only removes infection and seals the communication of the bone to the mouth. A crown then saves the tooth from crumbling under the eating pressures.
This way, your tooth can serve you for a very long time.
The first sitting involves the removal of the infected pulp and cleaning and shaping of the canals right up to the tip of the root. Time involved could be anything between 20- 45 minutes depending upon the number of canals, anatomy of canals, obstructions in the canals and access to the canals.
The second sitting in a clean tooth involves the filling of the canals and lasts between 10-20 minutes. In a painful tooth with pus discharge, the canals are washed with antiseptic solution and given a dressing. Canals are not filled until and unless they are completely dry and free of infection.
Next sitting follows the reconstruction of the tooth to its natural anatomy, before it is shaped or reduced for crown preparation. This marks the completion of root canal treatment.
The crown preparation involves two sittings where the tooth is reduced and the impression is taken which is sent to the lab for the fabrication of the crown.
Finally the crown is cemented in your next visit and checked for harmony.
Single sitting root canal is preferred in only about 20-30% of cases. It is recommended in cases of
· An accidental fracture of the tooth exposing the pulp,
· In case of a vital or bleeding pulp(nerve),
· Acute abscess draining through a sinus,
· intentional root canal treatment etc.
It is best avoided in old cavities, chronic infection cases. It is a modality of treatment indicated for certain conditions only.
"You can convince everyone to do one appointment Endodontics/ Root Canal Treatment, the hard thing is to convince bacteria to die in 2 hour."
by Rinaldo Mattar, Ricardo Affonso Bernardes
Cost of the root canal treatment varies from practice to practice. A good quality root canal treatment includes the cleaning of all the canals in a tooth. A good practitioner will always explain it on your x-ray. Always remember, you can either get it cheap or best. Cost and quality are directly proportional to each other so is the extent of damage the tooth has suffered.
Ask about cost only after we have examined the tooth and taken the x-ray.
Patient would blame the dentist and they would blame the companies who are selling medicaments and equipment at such a high cost, and institutions for the cost of education that is sky-high. But, if we peep inside and think otherwise, it is our laziness or some fears that keep us away from getting a simpler treatment like a filling done at its very onset. A root canal condition is an avoidable disease in 80% of cases if a regular check up at a dental office is followed periodically and any cavity is fixed with a minimum ordeal and a lesser expense.
Our team of Dental professionals at Align Orthodontics is well equipped to help you.
Prof. DR. ANIL SHARMA/ DR, SONIA SHARMA
visit us for Orthodontic Treatment, braces, invisible braces, root canal treatment, crown & bridge, white fillings, ceramic laminates & veneers, premium dental implants, bleaching, etc