Root canal treatment. Materials used in endodontics

Endodontic treatment is a complex procedure designed to preserve periodontal health.

It aims to remove the pulp from the pulp chamber and dental canals, followed by sealing them using various materials and techniques.

The dental pulp is found in the layer immediately beneath the dentin, both coronal and root, and plays a role in maintaining the vitality of the teeth.

Indications for dental pulp excision

• Painful sensitivity: the patient may present to the dental surgery with painful symptoms. This may be constant or present only during the consumption of sweet substances or liquids at extreme temperatures (very hot or very cold).
• The pain may be of mild intensity or may even wake the patient from sleep. All these are signs that guide the doctor to the final diagnosis.
• In cases where carious processes have exposed the pulp chamber, communication between the chamber and the external environment can result in infection at the tooth’s pulp level. Therefore, meticulous cleaning is necessary to prevent septic complications.
• Abnormal occlusal forces: constant additional pressure, even of low intensity, on some dental units leads to traumatization of the periodontium, which will respond by inflammation affecting the cortical bone.
• Hypersensitivity following preparation of teeth for prosthetic parts: if teeth are over-prepared for prosthetic work, they may develop sensitivity. Therefore, in certain situations the dentist may consider endodontic treatment before prosthetic treatment.
• Fistula, swelling: these are signs that suggest an outbreak of infection.

Under local anesthesia, the dentist will open the pulp chamber and then begin the procedures to remove the nerve, the dental pulp.

At the end, both the root and crown portions will be obturated, sealed, to prevent bacterial penetration.

Materials used in root canal preparation

Good irrigation of the dental canals is necessary for the complete removal of the nerve.

Sodium hypochlorite is the preferred choice for an antiseptic solution.

Following the use of each instrument, the pulp chamber must be irrigated thoroughly to allow organic residues to be evacuated and to create a bactericidal effect.

An additional material employed during this stage is a chelating gel based on EDTA, which aids in instrument maneuverability and the breakdown of calcium minerals.

Materials used in root canal filling

To achieve proper sealing of root canals, the chosen material must possess a certain level of fluidity to conform to the intricate anatomy of the majority of root canals.

It is recommended to use gutta-percha cones, which can be coated with a thin layer of cement to ensure adhesion to the walls of the canal.

Gutta percha cones are preferred and will be covered with a thin layer of cement to ensure adhesion to the channel walls.

Properties of the cement used for sewer plugging

• Radio-opaqueness: to be able to check the correctness of the radiological treatment
• Fast setting time
• Antiseptic and bacteriostatic action: to prevent reinfection
• Solubility: in case of failure of endodontic treatment, the material must be removable with certain solvents
• Good adaptation and tightness

The filling materials available today can be based on eugenol, calcium hydroxide, resin polymers or glass-ionomers.

Filling techniques also vary depending on the dentist but the end result is the same: removal of the source of infection, root canal sealing and prevention of recurrence.