Services > Endodontics

Infection of the vital tissues inside the tooth

Endodontic treatment is required when bacteria penetrate the tooth structure to the pulp as a result of tooth decay. It may also be necessary after trauma or in rare cases of certain diseases.

During root canal treatment, the dead tooth is cleaned from toxins and bacteria in three dimensions. This treatment makes it possible to preserve the tooth, ideally for many years. It requires a thorough mechanical and chemical cleaning of the entire root canal system to remove as much bacteria and inflamed tissue as possible. To achieve this, we use the most modern methods, such as electronic length measurement to prepare the root tip, ultrasound-activated irrigation with disinfectant solutions to clean the lateral canals as well, the rubber dam to protect you from the foul-tasting disinfectant solutions and to prevent bacteria from entering the saliva.

The Treatment

Treatment is usually performed in two to three sessions, depending on the severity and stage of the inflammation. After local anesthesia and placement of a rubber dam, the root canals are accessed through the occlusal surface of the tooth. An electrical measuring device then determines the exact length of the canals, which are then cleaned with flexible nickel-titanium instruments and special irrigants. Sometimes this is done mechanically with a torque-controlled motor. Various files of increasing diameter are used. After successful preparation, a bacteria-proof thermoplastic root cap is applied. The tooth is then temporarily sealed with a high quality filling until the final restoration (crown) is placed. In the case of single root teeth or severe destruction, it is advisable to add a post for stabilization.

Limitations and risks

If inflammation of the root apex and surrounding area occurs despite optimal treatment, surgical root apex resection is an option to ensure tooth preservation. This may be the case, for example, if bacteria remain in the finest lateral tubules that may not have been covered by the treatment, or if microcracks have formed in the tooth that can be re-infected by the oral flora.

In recent years, however, this treatment has been increasingly replaced by root canal revision, which is not only more comfortable for the patient due to improved procedures, but also has a higher success rate.

In this procedure, the old material is removed from the filled root canals and the root canal system is disinfected, prepared and filled. However, this procedure can only be successful if it is certain that no crack or fracture of the tooth was the cause of the failure. This diagnosis should be confirmed by a three-dimensional CBCT scan.