Endodontic treatment is one of the most common procedures.
If the dental pulp (nerves, arterioles, venules, lymphatic tissue, and fibrous tissue) becomes diseased or injured, endodontic treatment is required to save the tooth.
Root canal treatment is a dental procedure used to treat infected tooth pulp that would be otherwise extracted. The pulp is the soft tissue core of the tooth which contains nerves, blood supply, and connective tissue necessary for tooth health. This is usually caused when bacteria enter the pulp through a deep cavity or failed filling.
Root canal treatment is required when the dental pulp is irreversibly damaged and involves both coronal and apical pulp. Root canal treatment can also be carried out on teeth with doubtful pulpal state before placing post-retained crowns and overdentures. Root canal therapy is not only performed when pain relief from an infected or inflamed pulp is required. It is also done to prevent adverse signs and symptoms from the surrounding sequelae and promote the healing and repair of the surrounding periradicular tissues. An example of this is if there is trauma to a front tooth that has caused it to be avulsed from the bony socket; endodontic treatment is required following re-implantation to preserve the aesthetics and function of the tooth, even though there may be no adverse symptoms of the dental pulp, or pain present at the time.
Root canal treatment involves:
- Removing the damaged and infected pulp
- Shaping the entire root canal system
- Cleaning and disinfecting the entire root canal system
- Filling and sealing the root canal system
- Placing a direct restoration such as a composite filling or indirect restoration such as a crown
An apicoectomy is a surgical procedure through which the apex of a root is resected, and a root-end filling is placed, preventing bacterial leakage into the root canal system from the periradicular tissues. A microsurgical technique is used to carry out apicectomy, which improves post-operative healing. An apicoectomy can be carried out when a previous root canal treatment fails, and re-root canal treatment is not possible. This may be a result of anatomical features, such as root dilaceration, which can compromise the completion of cleaning and obturating the root canal system. Procedural errors including ledges or perforations may also be indications for an apicectomy.