Preparation techniques
What is the aim of root canal therapy?
- The removal of bacteria and infected or dead pulp from the pulp chamber and the canals
- Filling the root canals with dense, homogenous material that is tissue friendly
- To prevent the bacteria from spreading to the jaw bone
- Healing of already existing infections around root tips
The 7 steps to successful root canal treatment:
- First of all, we have to take an x-ray of the tooth to determine if root canal treatment is indicated or possible
- Then the tooth has to be isolated with a rubber sheet, called rubber dam. This prevents further contamination of the pulp chamber from bacteria in the saliva. It also protects you from swallowing the disinfecting irrigates or the very fine instruments.
- Once the dentist has direct access to the pulp, he removes the infected or dead nerve from the inside of the tooth. The toot can be anaesthetised for this if necessary. That is why root-canal-treatment usually is pain-free.
- The practitioner inserts small, flexible files made of titanium alloy into the root canal(s). The fit and position, as well as the overall length of the tooth are determined with x-ray.
- The root canals are cleaned and then widened their entire length to the root tip with these fine, flexible instruments. This can be done by hand or with a machine. It can be, depending on the number and shape of the root canals, a very time consuming exercise, and may require several appointments, especially when the root canals are very curved or narrow.
- As living bacteria can remain in the root canals even after thorough mechanical cleaning, an antibacterial medicament is placed into the canals after every treatment. It stays in place until the next appointment and the tooth gets closed with a temporary restoration/filling.
- At the final appointment the widened and cleaned root canals are filled with a cement-like material, as well as gutta percha points (rubber points) until the root canal is filled homogenously (“lateral condensation”). A different technique is the “Thermafil method”. Here the filling is made of a biocompatible tip that is coated with gutta percha, an elastic material. This gutta percha point is heated and becomes runny. Now it can spread into the entire root canal system, even into the fine side canals. At the end the density and length of the root filling is checked with another x-ray.