Microscope endodontic treatments are dental treatment methods that involve the use of a special microscope to view the inside of the root canals of teeth and treat them more precisely.
This type of treatment may be necessary when infections or lesions inside root canals cannot be treated by other methods, such as conventional root canal therapy.
The use of the microscope in this type of treatment can give the doctor much better visibility and a greater ability to locate and treat problems inside the root canals.
This can make treatment more efficient and effective, which can help prevent tooth loss and improve the patient’s oral health.
In general, microscopic endodontic treatments are considered a safe and effective procedure for treating problems inside the root canals of teeth.
However, like any medical procedure, there may be certain risks and complications that need to be considered before making a decision.
It is important to discuss all available treatment options with your doctor and make a decision that you are comfortable with.
Endodontic treatments are carried out when there is a continuity solution between the dental pulp and the oral cavity.
Most often, following the evolution of untreated carious processes, bacterial infiltration of the pulp chamber occurs.
When the carious process approaches the pulp chamber, pain occurs.
If the affected tooth has not yet been treated, the infectious process may progress and gradually lead to pulp mortification.
Other causes that can lead to tooth necrosis are:
Dental fractures – following trauma, especially among children and especially in the anterior region, tooth necrosis can occur. In this case, the tooth can be saved by applying a filling, if the size of the fracture is small and the pulp chamber involvement minimal.
Some local substances or substances that reach the terminal vessels that provide nutrition to the teeth can cause ischemia. These take the form of a disturbance of the dental vasculature. The lack of nutrient supply via the blood can lead to tooth decay.
The mortified, necrotic dental pulp may become infected, a phenomenon called gangrene. In these two situations, the treatment of choice is to remove the nerve.
Over time, there has been a trend among doctors to optimize endodontic treatments, increase success rates and reduce complications.
Endodontic treatment consists of the removal of the dental pulp as well as infected dentinal tissue from the dental roots.
Teeth have a variable number of tooth roots, between 1 and 3, each of which in most cases has a canal containing the dental pulp. The conformation of the roots is varied so that not all of them are straight, so that an efficient and straight access can be obtained at the time of pulp removal. Some roots are curved and endodontic treatment is complicated, requiring instrumentation appropriate to the clinical situation.
The operating microscope has also been adapted in recent years to dental surgery, particularly in endodontics. Its introduction has led to increased working speed and operating efficiency.
The microscope has certain characteristics that recommend it for endodontic treatments and beyond:
Microscope calibration Magnification – the image of the dental canals can be magnified so that the doctor can observe their features in detail.
This can translate into more efficient work, shorter sessions and increased therapeutic success compared to the traditional technique, where the doctor did not have a clear, three-dimensional image of the canals.
Magnifiers are used for magnification and are available in different versions and models.
Illumination of the operating field – the microscope offers the possibility of illuminating the area to be treated, also with the aim of facilitating work.
Image projection – the doctor can project the image of the operating field onto a screen, so he can explain to the patient in real time what is happening, for better understanding and communication.
A final advantage relates to the ergonomics offered by the microscope which allows the doctor to have a comfortable position. All this benefits the doctor’s quality of life and allows better control of the instruments.
Frequently asked questions:
Why does it hurt, does the nerve need to be removed?
Most likely there is a tooth decay which, untreated in time, evolves either painfully or in “silence”. This decay causes inflammation of the nerve (dental pulp).
There are other possible causes but with a lower incidence: dental fissure, dental fracture, inflammation of the surrounding tissue (marginal periodontitis or pericoronitis), perforation, dental avulsion, etc.
What can be done?
We will most likely apply root canal (endodontic) treatment.
Will it hurt during the operation?
No need to be scared, with the help of anesthesia everything goes traumatically. Most of the time treatments are done in one session and it doesn’t hurt at all.
Will it still hurt afterwards?
There may be some locoregional discomfort, which will subside with painkillers, depending on the condition being treated and the type of treatments used. This discomfort, if it occurs, will fade overnight until it disappears completely.
Every situation is different, but your dentist will give you personalized post-operative instructions to follow, and recovery time may be a little longer if you have had endodontic surgery.
You may be given painkillers and anti-inflammatories as advised by your doctor to reduce any pain and discomfort that may occur.
If the pain is severe and does not subside with medication, it is important to contact your doctor immediately.
How much longer will it hurt after I remove the nerve?
The duration varies from a few hours to a few days, depending on the pathology being treated and the type of treatments used.
If I have the nerve removed, will it never hurt again?
With proper care, teeth that have undergone endodontic treatment can be preserved on the arch for a long time, but it is possible that these teeth may heal improperly, with the appearance of painful manifestations months or even years after treatment.
If this happens with treated teeth, you have a second chance to save the tooth with a retreatment under a microscope.
Why is there a chance of more pain if the nerve has been removed?
Causes can be:
The canals are curved and could not be properly cleaned by classic root canal treatment (mechanical and chemical treatment)
Presence of additional root canals with a different anatomy that were not detected and treated initially
Delay in placing a protective crown on the tooth
Saliva contamination at the time of root canal filling due to poor isolation
An infection caused by new damage, a damaged crown or filling exposing the tooth to bacteria
The appearance of cracks or fractures
What can be done in this situation?
Endodontic retreatment is performed but under a microscope so that the margin of error is reduced as much as possible.
Microscopic retreatment How is retreatment done under a microscope?
The procedure for endodontic retreatment of a tooth consists of removing the old root filling, cleaning the canals and permeabilizing those that were not discovered during the first endodontic procedure.
Periapical infection, if present, will also be removed. All canals will be filled up to the apex level, without going beyond it, with a root canal paste.
If even microscopic treatment does not solve the situation, what should be done?
There is the alternative of apical resection or, as a last resort, tooth extraction.
Prosthetics can then be done by dental bridge or dental implant.
Why retract it if it didn’t work the first time, why not remove it directly?
Advances in dental technology are taking place every day, and endodontics is no exception. So when you decide to redo endodontic treatment, your dentist may use techniques that weren’t available when you originally had root canal treatment.
How much does it cost me?
Microscopic treatment starts at 500 lei and, depending on the complexity of the case, can go up to 800 lei.
What do I do next?
To observe the progress of your treatment, your doctor will schedule you for a consultation 7 days after the operation.
The swelling and pain should disappear within two weeks; however, it is important to schedule an appointment with your dentist as soon as possible to cover the treated tooth with either a crown or a crown filling.
