Root Canal Treatments (Endodontics)
Endodontics is the term used for all forms of root canal therapy. Non-surgical endodontics includes root filling, pulpotomy, and pulp capping, while surgical endodontics is correctly called apicectomy.
Principles of endodontics
Pulpitis leads to pulp death. This in turn eventually leads to an acute alveolar abscess, which is a very painful condition. To prevent this chain of events, endodontic treatment or extraction is required whenever the pulp is irreversibly inflamed or dead, or when an alveolar abscess is already present.
The aims of root canal therapy are as follows:
- Complete removal of the pulpal contents- extirpation
- Shaping of the root canal to allow thorough irrigation
- Irrigation with antibacterial disinfectants such as sodium hypochlorite or chlorhexidine
- Removal of these irritants and any residual bacteria from the root canal
- Filling of the root canal with a non-irritant, impermeable material- obturation
- This seals ant further bacteria off from the periapical tissue fluids
- Allow the restoration of the tooth to full function, either by filling or by cementing a crown or inlay
The same procedure provides drainage and complete cure of an existing abscess. The root canal filled tooth will then function just as well as one with a normal pulp. Success depends on achieving a leak-proof seal at each end of the root canal, and thereby preventing micro-organisms from entering or leaving it.
Causes of pulpitis
The commonest causes of pulpitis is exposure of the pulp. This allows mouth bacteria to enter the pulp chamber and infect the pulp. Exposure of the pulp may be caused by:
- Accidental exposure during cavity preparation
- Fracture of the crown
Even when the pulp is not exposed, pulpitis can still occur. The causes are:
- Irritation of an unlined filling
- Excessive heat during cavity preparation, such as the use of an air turbine headpiece without water spray
- Impact injury
The aim of endodontic treatment is to attempt to save the tooth from extraction. When a patient presents with obvious signs of an acute infection, a course of antibiotics therapy may be required before treatment of the tooth can commence.