Perfectly personalized denture – Flexible implementation process – With the latest tools

Dentist: Dr. Melinda Kálcsev; Dr. Viven Farkas

What is root canal treatment,
and when is it necessary?

The most common cause of toothache is inflammation of the living tissues within the tooth or the tissues surrounding the tooth. This inflammation and pain can be effectively eliminated through root canal treatment.

Inflammation can also develop around teeth without noticeable symptoms – if bacteria enter the body through already dead/nonsensitive teeth. Often, these can act as foci-center of infection and cause damage to other organs. During focus research, we attempt to identify these asymptomatic inflammations – and here, too, root canal treatment can eliminate the inflammation.

During root canal treatment, we remove irreparable tissues from inside the tooth, disinfect the inside of the tooth and the root canals, and then fill them with a very well-sealing special filling material so that bacteria cannot enter the body through the tooth.

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What are the benefits of root canal treatment?

In the case of successful root canal treatment, it is not necessary to remove a tooth with an infected interior or a tooth causing an infection in its surroundings.

Teeth with broken crowns or teeth causing the center of infection are often salvageable with the appropriate technique.

The greatest advantage of root canal treatment is, therefore, that severely damaged teeth can still be saved. Clinical studies have shown that in the long term, multiply treated, damaged teeth with root canal treatment are more durable and cause fewer complications than currently available implants. Therefore, when a tooth can be saved with root canal treatment, preserving it is the most practical solution.

What is the treatment process, what tools, what
techniques are used?

The first step in every case is determining the cause of the symptoms and establishing a diagnosis. In our practice, we have assistance not only from traditional X-rays but also from a high-resolution, low-dose CBCT device that provides a three-dimensional image of the tissues around the tooth. Often, inflammations that are not visible on conventional X-ray images can be detected with this advanced technology.

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A significant help in cleaning the root canal is achieved by isolating the tooth from the rest of the oral cavity. For this purpose, we use a “rubber dam”, protecting the tooth from saliva and bacteria in the mouth. At the same time, we safeguard the gum and mucous membrane from the more aggressive disinfectants used during treatment.

The root canal treatment begins with cleaning and disinfecting the pulp chamber and the root canals. Root canals are often very narrow, occasionally widening or branching, requiring thin yet sturdy instruments for cleaning to avoid damage during the procedure. Very thin yet strong tools are needed for cleaning to ensure they do not get damaged or break during the treatment.

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Initially, the very narrow canals are widened and shaped using fine manual instruments/root canal files. After reaching a certain width, we use mechanical drills. These are sensitive instruments specifically designed for root canal treatment, performing very slow one-way or two-way rotations, which automatically stop upon reaching a certain force/tension, thereby reducing the risk of instrument breakage.

In our clinic, we use new mechanical root canal instruments for every patient to prevent material fatigue and thus reduce the risk of breakage.

The disinfection of the complex root canal system and the dissolution of infected material are performed with various solutions during and after achieving the desired root canal size/shape.

After drying the canals, we seal the apical part of the root with a very well-sealing cement, which we compact with “small plugs” made of natural resin (gutta-percha). The remaining canal sections are also filled/”injected” with heated/liquid gutta-percha using a device with a heating tip specifically developed for this purpose. For severely infected teeth, a medicated filling is placed in the canal for a few weeks before the final root filling – during this time, the tooth is also covered with a temporary filling, and the final root filling is done in a subsequent session.

To locate narrowed root canals and check the cleanliness of canal walls, we use various magnification tools as needed in our clinic. With magnifying glasses, 2.5-7x magnification can be achieved, while our microscope provides 25-30x visibility of the treated area.

In freshly root-treated teeth, the complex structure of the canal system and, in older root treatments, potentially irremovable filling material or an existing root post may hinder the successful completion of traditional root treatment. In most cases, there is still an option to save the tooth with surgically performed root filling. Under local anesthesia, the root apex of most teeth can be accessed completely painlessly through a small surgical exposure. We remove this root apex along with its infected surroundings using an ultrasonic device, with specially designed heads that can also shape the root canals for so-called “retrograde” filling from the root apex. This procedure requires complex equipment and expertise. Simply removing the root is unsuccessful in more than half of the cases according to clinical studies, which is why we always perform filling from the root apex in our clinic.

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Take care of your teeth!

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