Endodontics
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Endodontics
Endodontic treatment is indicated for deep caries when the disease progresses to the pulp and then to the periodontium. The inflamed paranasal ligament in the periodontal crevice gradually disintegrates, the gums around the apex are saturated with pus, which spreads to the periosteum. The tooth becomes loose because of this, and if the periodontal disease is not treated, canal cleaning will not help and it will be necessary to remove it either completely or partially.
Other indications for treatment are fracture or dislocation of the tooth and preparation for metal-ceramic prosthesis. In order for the root to support the prosthesis, the endodontist inserts pins into the canals, which support the tooth walls and distribute the stress evenly.
Endodontics is contraindicated if the periodontium is thinned or the coronal part is destroyed and cannot be restored. Cleaning and treatment are also contraindicated in cases of acute or chronic oral mucosal disease and when access to the affected tooth is difficult and canals are technically complex to treat.
Stages of endodontic therapy
Prior to treatment, the endodontist will assess whether the pulp is alive, determine the orifice of the root canals and the condition of the periodontium. They will prescribe a thermal test, electric test, X-ray or 3D diagnostics. Based on the results of the examination, it will be decided whether the pulp can be saved or will have to be removed and whether only endodontic treatment will be effective or whether the root or the whole tooth needs to be removed.
In endodontics, a distinction is made between conservative and surgical treatment. The endodontist chooses the method based on the ease of access to the pulp chamber. In the conservative approach, the instrument is introduced through the crown; in the surgical approach, it is inserted through the apical part. To get to it, the gums are cut and the mucous membrane is peeled off.
The specifics of endodontics also change depending on the pathology:
- Complicated caries. The dentist opens the carious cavity, cleans it layer by layer from the destroyed enamel and treats it with antiseptic solutions. If the coronal part is severely damaged, a prosthesis is fitted in its place.
- Pulpitis. If the pulp is inflamed, but not dead, the specialist directly or indirectly covers it with calcium hydroxide. First, it is exposed and a medical paste is applied to create a new protective layer or dentin “bridge”. Second, the tooth caries is washed and a paste is applied to the bottom of the tooth without opening the pulp chamber where the pulp is located. If the pulp is destroyed, the endodontist removes it or amputates the damaged area.
- Periodontitis. In case of inflammation of periodontal tissues, pus accumulates around the apex and flows out of the inflamed root. The endodontist inserts the instruments into the pulp chamber, removes the purulent matter and flushes out the infection site.
- After treatment and cleaning, the roots are filled with filler material – gutta-percha pins and pastes.
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Are you looking for a quality dental care? Visit our clinic at Jablonecká 712 in Prague. Our experienced and friendly dentists will provide you with the best care for your teeth.
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Jablonecká 712, 190 00 Praha 9 – Prosek
Address
Jablonecká 712, 190 00 Praha 9 – Prosek