Endodontics
is the specialty of Dentistry directed to the treatment of pathologies of the pulp (usually referred as nerve).
The dental pulp is located inside the tooth and is surrounded by the hard tissue - the dentin. It is responsible for nutrition and
tooth sensitivity through the blood vessels and nerves that constitute it.
Lesions of the dental pulp may rise from trauma, fractures or deep cavities. Symptoms indicative of an endodontic problem include spontaneous pain, prolonged sensitivity to cold and / or heat, and discomfort to touch and chewing, with the most common signs being abscess or fistula (small blister of pus in the gingiva).
In cases of necrosis or irreversible inflammation of the dental pulp, endodontia (devitalization) is the only solution to save the tooth and avoid further complications.
In addition to eliminating the pulp pathology, the endodontic treatment allows, together with the subsequent reconstruction, allows to restore to the tooth the masticatory function. There is also the possibility of performing an endodontic retreatment, which consists of a new treatment of the root canals. It should always be the first option in teeth whose previous endodontic treatment has failed.
In a retreatment, all the existing contents inside the root canal system are removed and a new disinfection, preparation and three-dimensional obturation of that root canal system is executed. After retreatment, tooth restoration is performed.
The first step of endodontic treatment involves the removal of infected or necrotic pulp.
Under local anesthesia and using appropriate drills, an opening is made in the back of the affected tooth (in the case of a previous tooth) or in the crown (in the case of molar or premolar teeth), through which is removed all dental pulp tissue or remains of sealing material from previous endodontic treatments.
After the pulp or remains of sealing material from previous endodontic treatments has been removed, the pulp chamber and root canal system present in the roots are properly disinfected in order to eliminate all bacteria. After conveniently prepared, the canals are able to receive the filling, normally performed with Gutta-Hanger, a derivative of vegetable resin. When the canals are filled, the tooth is hermetically sealed with cement and restored in order to regain its natural appearance.
As the duration of endodontic treatment depends on several factors, in situations where it is not possible to perform the complete treatment in only one consultation, a temporary restoration is placed in the access opening, with the purpose of protecting the tooth between consultations.
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