Root Canal Treatment is the procedure done to preserve the infected tooth. This procedure involves removing the damaged or infected pulp, treating any infection and filling the empty canals.
Root Canal Treatment procedure is started by drilling the enamel part of the tooth, that is topmost portion of the tooth. First the Dentist enters the pulp chamber, where the infected pulp is present. The next step is exploration of root canal, removal of the remaining pulp tissue and infected tissue. The infected pulp is then drilled out with the help of long needle shaped drills called files, Remears, K-flex, Headstroem ( H-files), etc.
After successful removal of the pulp, the root canal is disinfected with the help of intracanal medicaments like essential oils (eugenol), phenolic compounds, Sodium Hypochlorite and iodides. The disinfection procedure is done by using a plastic pipette or a syringe.
Finally filling (obturation) of root canal is done with an inert filling material called gutta percha.
There are different filling techniques practiced in dentistry like Lateral condensation technique, Vertical condensation technique, Sectional method. The most commonly accepted method of filling is lateral condensation and vertical condensation.
The main disadvantage of gutta percha is its inability to bind with the root canal. Therefore root canal cements are used to bind the root canal and gutta percha. They provide an excellent seal, when set, in between root canal and gutta percha. The most commonly used root canal cements are Zinc oxide Resin Cements and Calcium Hydroxide Cement.
For a tooth to undergo root canal treatment, diagnosis plays a very important role. First step of diagnosis is by observing symptoms that can be classified as:
Subjective symptoms, which are experienced by patient and reported to the clinician
Objective symptoms, that are observed by the clinician through tests.
Root canal treatment procedure can be performed in vital (living ) tooth or in non-vital (non living ) tooth.
When a patient complains of severe toothache due to decay or when a patient meets with an accident, root canal treatment is advised. The most important step before starting the treatment is proper clinical diagnosis, which is based on the subjective as well as objective symptoms. The initial subjective information is supplied by the written medical history form, which is completed by the patient. Further information is gathered by the clinician (objective symptoms) like patients chief complaint, past medical history, past dental history, current medical and dental status.
The best treatment is prevention; one should place a pulp protective base under all deep fillings (restorations). Application of zinc oxide eugenol as a temporary sedative filling can be done, normally pain disappears, if the pain persists, the pulp should be removed. In case of acute irreversible pulpitis, the only treatment is pulpectomy.