Muhsin Yazıcıoğlu Caddesi No: 8/1, Çukurambar/Çankaya

Root Canal Treatment

Root canal treatment becomes necessary due to deep caries, fractures and cracks, various traumas and inflammation in the pulp (the vascular and nerve bundle of the tooth). If the decay has progressed so far that it can infect the vascular and nerve tissue of the tooth, all of this infected tissue must be cleaned and filled with tissue-friendly canal filling materials so that the canal length is complete.

In vital (live) teeth, local anesthesia is applied before root canal treatment and pain sensation is eliminated. If the tooth to be treated is devital (lost its vitality), root canal treatment can be performed without anesthesia.

The pulp, which consists of the blood vessels and nerves that feed the tooth, is removed during root canal treatment, the root canals are disinfected, expanded, shaped and finally filled with tissue-friendly root canal filling material. Root canal treatment is usually completed in one session, but may require several sessions depending on the infection status of the tooth.

Root canal treatment is the last treatment option before tooth extraction to save the tooth. With a successful root canal treatment, the swelling and pain in the tooth is completely eliminated. After root canal treatment, the inflammatory tissue initially present at the root tip heals over time. During or after root canal treatment, teeth may be sensitive to touch and chewing for a while. The success of root canal treatments and the long-term retention of root canal treated teeth in the mouth may vary depending on the amount and resistance of the infection in the tooth, the anatomical structure of the tooth roots, and the amount of remaining tooth tissue. However, in most cases, root canal treated teeth can serve in the mouth for many years.

Depending on the loss of tooth tissue, the amount of remaining tooth tissue will determine whether the restoration to be made will be a filling, overlay or endochron (one of the porcelain filling types) or a porcelain crown. In cases where there is little loss of tooth tissue, permanent restorations are completed with composite fillings, while in cases of excessive loss of tooth tissue, inlays, onlays, overlays or endocrons or porcelain crowns are preferred.

Root Canal Treatment in Teeth with Periapical Lesions

As a result of the patient not consulting a doctor despite a long-term infection in the tooth or due to incomplete root canal treatment, the infection progresses around the root of the tooth and spreads to soft and hard tissues. The destruction of the tissues results in bone destruction due to infection at the root end of the tooth, which is detected by radiography.

In such teeth, root canal treatment is performed to reach the root tip of the tooth so that the inflammation at the root tip can be dried. In this type of teeth, root canal treatment may not be completed in a single session. After the root canal treatment is completed, radiographic follow-up is necessary to observe healing and new bone formation. With small periapical films taken from the root tip of the tooth, 3-6 monthly controls are performed. As a result of radiographic follow-up of the destruction of the bone, new bone formation and complete healing can be observed, or as a result of insufficient healing, further treatment options such as surgery (apical resection, etc.) may be decided. In cases where root canal treatment is not performed, the progression of the lesion (bone destruction) may continue and the tooth may become unable to attach to the bone in the jawbone. The tooth that becomes mobile may need to be extracted.

Root Canal Treatment in Teeth with Open Appendix (Apexification)

Apexification is the process of directing the mineralization of the existing wide root tip or occluding the root tip with a mineralized tissue in order to complete the root canal treatment when root canal treatment is required due to caries or trauma in teeth that have not yet fully completed root development (immature). It has been reported that direct root canal treatment in teeth with an open root tip may cause overflow of the medications, paste and even canal filling materials applied out of the root tip. Many techniques have been proposed for apexification to date. In recent literature, successful results of cases in which MTA (Mineral Trioxide Aggregate) was used with plug method are reported.

Renewal of Root Canal Treatment (Retreatment)

In cases such as re-intensification of pain for any reason in a tooth that has undergone root canal treatment, re-development of abscess in the tooth, the procedure that includes the removal of the existing root canal filling, re-expansion of the canals, disinfection, if necessary, one session of dressing the relevant root with medication and re-clogging the root with root canal filling is called retreatment. Since this procedure is the process of repeating the existing root canal treatment, it carries a little more risk than the first time root canal treatment. These risks may increase or decrease depending on the final condition of the tooth, the physician explains the existing risks to the patient and the retreatment is attempted with the patient’s consent.

In case of failure of this treatment, which carries risks such as perforation of the root during the removal of the root canal filling (the root is perforated while trying to overcome the obstructed area and the canal file comes out of the unwanted part of the root), a root with a thin root structure may crack with the second expansion due to the expansion in the first root canal treatment, and the root tip may not heal completely due to the presence of resistant microorganisms at the root tip, or in the presence of roots that are so bad that retreatment treatment cannot be performed at all, tooth extraction is required.