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ROOT CANAL TREATMENT - RESECTION

What is a root canal (endodontic) treatment?
Under the outer enamel of your teeth and in the interior of the dentin there is a cavity with soft tissue which is called dental pulp, which contains the nerves of the tooth, veins, arteries and lymphatic vessels. The root canals are very small and thin tubes, that begin branching out from the upper part of the pulp to the edge of the root. A tooth has at least one and usually no more than four root canals. In rare cases, five or even six root canals have been found.

Why do I feel pain?
When the pulp gets infected, due to some deep cavity that could have been caused by dental caries, can become necrotic. The destroyed or necrotic dental pulp increases the circulation of blood and cellular activity. Thus the tooth cannot relieve by itself the pressure that is applied in its interior. You usually feel tooth pain when you bite something with that tooth, during chewing, as well as when it is in contact with hot or cold foods or beverages, or you can even feel spontaneous pain, not necessarily after some stimulus.

Why do I need root canal treatment-resection?
As the tooth cannot be healed by itself, without treatment, the infection will spread, the bone around the tooth will begin to degenerate and the tooth might need to be extracted. In most of the cases the pain gets worse and the patient needs immediate dental care. When the tooth remains untreated for a long time period, the only alternative is usually the extraction of the tooth. This can make the adjacent teeth bend, causing difficulties. Although the extraction is cheaper, the gap that remains will require the placement of an implant or a bridge, which will eventually cost must more than the root canal treatment-resection. When you have the choice it is always far better to keep your own teeth in your mouth by treating them.

How is the root canal treatment-resection performed?
Root canal resection is a procedure which is performed in order to remove the destroyed or necrotic pulp of the root canal of the tooth, through the cleaning of the “sick” pulp and the subsequent filling of the root canal. The root canal is filled with gutta-percha, an elastic material similar to natural rubber, so that the recurrence of the infection in the tooth is avoided. Subsequently the tooth is permanently sealed, or a post and a crown made of porcelain are fitted. This allows the patients to keep their teeth within their oral cavity for many many years.

What does an root canal include?
After your dentist has examined your teeth and has recommended a root canal treatment to you, he can either perform the root canal treatment himself/herself  or refer you to an endodontist.

 

What is an endodontist?

Endodontists are dentists with three additional years of specialty training in the techniques and procedures of the endodontic (root canal) treatment (resection). Apart from the treatment of usual cases, they are specialized in performing complex surgical procedures. They usually have to deal with and treat difficult cases, such as teeth with unusual or complex root structure or small and narrow root canals. Their expertise, specialization and experience are valuable when the endodontic surgery is necessary, or under very difficult working conditions. Thanks to their knowledge and expertise they can be effective when working with disabled people, people who are not capable to fully open their mouth, very old people whose teeth present particularities, people with a bad health history or people that cannot sit in the dental chair for long, due to health reasons. In all of the above cases, speed and precision in the course of treatment are quite important because the treatment is completed in one and only session, very rapidly, and the chances of success are extremely high. This is very important in cases that the slightest inflammation in the mouth could be very harmful to the patient’s health. Such are the cases of prosthetic heart valves, kidney diseases, orthopedic prostheses and other health problems, when we want to avoid an inflammation.


What is the procedure of root canal treatment?
Root canal treatment in a specialized dental clinic can be completed in just one session and its duration varies from half an hour to two hours depending on the difficulty and the extent of the inflammation. It is now known that root canal treatment is completely painless and has nothing to do with the horrific stories about resections that hurt unbearably during the procedure.

Initially local anesthesia is performed so that the area gets numb. Then, an elastic membrane is placed around the tooth so that it is isolated. The tooth is examined under a microscope so that dental caries are properly removed and all root canals are found. Medicines are inserted into the root canals in order to fight bacteria. After the disinfection of all the root canals the endodontist fills the root canals with gutta-percha. After the root canal treatment procedure, the permanent filling can immediately take place.
If a lot of dental tissue is missing, it is possible that a metal post is fitted over the root canal so that the tooth is reinforced. When the area is filled, it is permanently sealed. Finally, a crown made of porcelain is usually placed over the tooth so that its structure is reinforced and its appearance is improved in the case that there is a significant change in color that cannot be addressed by a simple whitening.

What is the rate of success of root canal treatment-resection?

99% of root canal treatments are performed with full success. Of course this is the actual rate only if the endodontist is very good at his/her profession. However, in some rare cases, the procedure must be repeated or a surgical operation must be performed due to the existence of “sick” branches in the canal. This will be noticed, as the pain will recur.

 

What happens after the treatment?

The inflammation of tissues may cause a slight discomfort for a few days, which can be easily controlled with the simple use of painkillers. The control of the tissues’ healing, in the cases where there are extended abscesses, is performed through a repeat examination of the patient.

Simple painkillers that you can buy in a drugstore without a doctor’s prescription, usually manage to relieve you. You should always remember that, if you felt pain in your teeth before you came to us for treatment, it may take some time for your teeth to heal and return to their normal condition.

Do I have to do something in particular?
In the first few days after treatment, just try not to bite and eat with the teeth of the particular area.

When must I have my tooth filled?
After your root canal treatment is completed, a temporary filling is placed. The tooth continues to absorb nutrients from the adjacent tissues, but it must be permanently restored. You must permanently restore your tooth. The type of restoration that will be selected depends on the location and condition of the tooth. It is also important that the restoration of your tooth is performed soon, in 10-15 days at the most, because the temporary filling will not last for long.

What is the life expectancy of my tooth after root canal (endodontic) treatment -resection?

When the root canal treatment is performed in the scientifically right way your healed tooth can last for the rest of your life. This tooth needs, as the rest of your teeth,  proper care, that includes teeth washing, the use of dental floss and, which is the most important, a visit to your dentist every six months, so that you have your teeth checked and cleaned. This is very important, as the examination can prevent problems, which, if their development is not prevented, may cause significant problems, for example a minor decay just needs a simple feeling, a more extended dental caries may require root canal treatment, or a crown made of porcelain, or even a tooth extraction if dental caries have spread very deep under the gums.

 Constantinos Laghios, Dental Surgeon-Endodondist, M.S


Rear case of root canal treatment in a molar with 5 canals


Extremely rear case of root canal treatment in a molar with 6 canals. In this case experience, knowledge and microscope are necessary


Tooth with huge lesion: Extraction, placement of bone graft and subsequently implant had been advised by a specialist


Root canal treatment with incision of the abscess was done. Eleven months recall shows complete bone healing



1.A decayed tooth with a doubtful , problematic root canal treatment


2.Initial x-ray with an incorrect, unfinished root canal treatment, in a patient currently facing serious pain


3.Α correct root canal treatment processed through a high-tech “Carl Zeiss” dental microscope


4.A successful root canal retreatment, reaching the very last millimeter of the apex


5.Flap


6.Placement-adhesion of a post


7.Placement of resin composite


8.1-week recall: we can notice that the successfully endodontically  treated tooth remains as an abutment in the existent bridge without being
necessary to replace the old bridge with a new one so the patient avoided any possible discomfort and financial burden as well