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Τετάρτη, 24 Οκτωβρίου 2012

Root Canal Treatment(RCT)

Today's post will be about  the endodontic or root canal treatment . 
 To be honest ,I can not really be sure what someone thinks when he hears the term root canal treatment. 
They might think something like that 

 
  or something or like that



  Certainly in both cases they are wrong!

 The endodontic or root canal treatment is the process in which the pulp of the tooth (or the nerve of the tooth), due to the fact that it has been contaminated by bacteria(microbes), is removed and replaced by a biocompatible material, so that the tooth can remain functional inside the mouth. 

  In the the past, and I mean up until 30 years ago,it wasn't a biologically accepted treatment option, but the dentist simply put a necrotic agent of the pulp (nerve), usually arsenic, and the tooth stopped hurting due to pupl necrosis.Naturally such teeth were doomed to be extracted, but we're talking about an era where knowledge of dentistry and dental education were very low.

Let us see the stages of root canal treatment together. 

We said that the nerve of the tooth (the pulp), has been exposed to bacteria(microbs).This can be happen due to damage of the tooth, ie from caries.Another possibility is a fracture of the tooth.

                                            

.As we see in the image below the decay has reached the nerve ( pulp) of the tooth.In this case we do the following:   

                           

 
  • Perform local anesthesia and then excavate the tooth,to remove dental caries and gain access to the root canals (canals where the nerve of the tooth is located). The whole procedure is done by isolating 
either with cotton swabs

   
 
 
or with a rubber dam
 
  
 
as the seen in the pictures.
Of course Greeks patients are not very familiar or happy with the use of the rubber dam, because they feel that it chokes them.
  •   We remove the nerve using endodontic files and at the same time we prepare the walls of the tooth to place the biocompatible nerve substitute.These endodontic files (some patinets refer to them as"hooks") are those depicted in the picture below.  
 
  • Between the different sizes of endodontic files we irrigate the inside of the tooth with an antimicrobial agent, which may be either sodium hypochlorite (or chlorine) or chlorhexidine or a combination of both under suction.This irrigation is done with a syringe and directly into the root canals,were the tooth nerve used to be.
  •  We then proceed in sealing the tooth with a biocompatible material.Usually guttapercha is used  in the form of cones. Guttapercha cones are these ones  

 
  • Finally, we restore the tooth.This depends on how much tooth structure is remaining.We can seal it with a filing or a crown. All these are described in the video below.
                                     

  Apart from the use of manual instruments,which I've shown above, now rotary instruments are used in the procedure of  root canal tretment therapy, doing the same job with the manual, faster.
  How many appointments does it take for the root canal treatment? Depending on the tooth and the philosophy of the dentist,it takes one up to four appointments, if ​​each stage is done separately. If the tooth is accompanied by a swelling,and during the tretment it there is a continuous flow of pus or a tooth abscess, appointments may increase. Between visits the tooth is covered with a temporary filling material,and if pus is present,we place a medicine (usually calcium hydroxide), to absorb the pus. You may be given antibiotics if the swelling is big.
  Who does the root canal treatment procedure? Both the general dentist and the specialist endodontist. There are some general dentists who do not perform root canal treatments, and there are some endodontists who believe that they and they alone can perform root canal treatment therapies.These two are the extremists of the dental profession.
  What is life expectancy of a root canal treatment? In this question I can not answer with precise.A root canal treatmant is a dental treatment. It can be for a long period of time,some times for a lifetime,but problems can also delelop.For this reason when recalling the patients for preventive treatment therapy an x-ray (radiographic) examination should be done.
 
      I hope I've helped a bit.Don't forget to smile!

                      

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