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 removal
Painful sensitivity: the patient may present to the dental surgery with painful symptoms. This may be constant or present only during 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.
Carious processes that have opened the pulp chamber: communication of the pulp chamber with the outside cause infection at this level of the tooth, so thorough cleaning is required 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 with 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 first-choice hygienic solution used in root canal preparation.
After the passage of each instrument, the pulp chamber must be irrigated thoroughly to allow organic residues to be evacuated and to create a bactericidal effect.
Another substance used at this stage is EDTA-based chelating gel, which is useful in facilitating the passage of instruments and disorganizing calcium minerals.
Materials used in root canal filling
In order to ensure that root canals are sealed, the material used must have a certain fluidity in order to adapt to the complex anatomy of most root canals.
Gutta-percha cones are preferred and will be covered with a thin layer of cement to ensure adhesion to the canal walls.
Properties of the cement used to make the canal filling
Radio-opaqueness: so that the correctness of the radiological treatment can be checked
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 fit 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.