Endodontics

Endodontics is the branch of dentistry concerned with the treatment of the endodontium—the internal space of the tooth that contains the dental pulp, connective tissue, and nerve endings.

Endodontic treatment is required when the pulp degenerates due to infectious or traumatic events, which cause inflammatory processes, hypersensitivity, and a loss of vitality within the pulp itself.

The primary cause of pulp compromise is deep tooth decay. This very common condition allows bacteria and their toxins to penetrate the outer layers of the tooth and reach the dental pulp, triggering painful inflammation (pulpitis). If left untreated, decay can lead to a loss of tooth vitality or a periapical infection (abscess).

Endodontics involves removing the inflamed or necrotic pulp from the tooth, followed by filling the root canals. It can be performed using either manual or mechanical techniques. The dentist utilizes endodontic therapy with the ultimate goal of saving compromised teeth and avoiding extraction.

The phases of a root canal treatment include:

1. opening the pulp chamber;
2. determining the working length;
3. shaping the canals with Ni-Ti (nickel-titanium) rotary instruments, followed by irrigation, disinfection, and thorough drying;
4. three-dimensional obturation (sealing) of the root canal system up to the anatomical apex.

In cases where the tooth structure is severely compromised, the dentist will perform a customized, detailed restoration and evaluate whether to recommend a dental crown to protect the treated tooth.

Teeth that have already undergone root canal therapy may, in some instances, require a new endodontic procedure known as a root canal retreatment. This technique involves reopening the compromised tooth to treat pathologies or infections that have developed after the initial canal therapy.