Endodontics

Endodontics

Endodontics is the area of Dentistry whose objective is the treatment of the tooth as a whole, aiming at the healing of tissues inside and around the tooth.

It consists of removing the inflamed or infected pulp from the canals, disinfecting and filling them with a material that prevents bacterial proliferation.

What are the indications for root canal treatment?

Acute apical periodontitis (AAP)

Etiology:

  • Extension of pulp inflammation to periapical tissues
  • Occlusal trauma from bruxism

Signals and symptons:

  • Moderate and severe spontaneous pain
  • Pain when chewing or when there is occlusal contact
  • When there is pulpitis: exaggerated response to the hot and cold test
  • When there is necrosis: tooth does not react to tests

Chronic apical periodontitis

Etiology: it is a consequence of tooth necrosis

Signals and symptons:

  • Does not react to hot and cold tests
  • May present pain to percussion
  • There may be tenderness to palpation

Acute apical abscess

Etiology: exacerbation of acute apical periodontitis and necrotic pulp. There is a severe inflammatory response

Signals and symptons:

  • Moderate to severe pain
  • Pain on palpation and percussion
  • Negative thermal and electrical stimuli: Necrosis
  • At radiographic level it presents purulent exudate

Chronic apical abscess:

Etiology: necrotic pulp with severe inflammatory response

Signals and symptons:

  • Fistula that passes through bone and oral mucosa
  • The purulent exudate may drain through the fistula

Thus, it is recommended to perform a root canal treatment when the pulp is irreversibly damaged or necrotic with or without evidence.

Sometimes after root canal treatment, retreatment or endodontic surgery may be necessary. This is because there is persistence or development of pathology after filling.

Endodontics stages

  1. Removal of caries (if successful) to prevent contamination of tooth canals.
  2. Removal of the root canal nerve (responsible for pain and sensitivity)
  3. Introduction of files to clean channels well. Files of different sizes are introduced and between each one is irrigated to disinfect.
  4. The canals are widened with files until the ideal size is found to fill them with biocompatible material;
  5. After the procedures described above, the tooth is restored to regain its functionality.

Appointments

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