Endodontics is a field of dentistry that focuses on diseases of the dental pulp (tooth nerve) and their complications (periodontitis, apical granuloma, radicular cyst).

The main purpose of endodontics (root treatment) is the proper cleanup, processing (including disinfestation) and hermetic obturation (filling) of the root canals and tooth recovery. To achieve this goal we use the most modern methods and materials – insulation of the working field with a rubber dam, ultrasonic tools for opening orifices (channel entrance), machining of root canals with NiTi tools electrometric determination of working length with apex locator, precise obturation of root canals. Thanks to the digital x-ray equipment as well as immediate photo after filling we have full control over the treatment.

Sometimes endodontically cured tooth may cause you some problems – pain or discomfort may occur. This can be due to:

• If the channels are not fully processed
• If sterility is compromised during processing
• No additional channel detected and processed
• Finishing the tooth with a crown or permanent filling is delayed
• If new cavity has arisen to cause re-infection
• A fracture, placed defective crown or periodontal disease in the area create a risk of re-infection.

In that case you should consider a re-treatment. Your dentist has to drill the tooth again in order to remove old material located in the canals. That’s why multiple sessions might be needed. The tooth is strictly inspected for any new or missed canals.

When an unexpected granuloma is found on the x-ray, a temporary drug is placed in the canal, it needs to be replaced from time to time. Usually granuloma teeth are in extraordinary color. The main problem with such diseases is that they proceed relatively asymptomatically. When you feel like your tooth is out of place, painful or even unfamiliar the chronical infection situated in the bone grows better, then you realize it’s symptomatic. Dull pain occurs, the mucosa may become red, due to blood retention, there may be an outflow at the site of the fistula, if any, pus may leak. Sometimes, when the tooth is open, an unpleasant odor can be felt.

When treating a tooth with granuloma, a medicine is placed in the canals, which must be changed periodically. At each visit, the healing process is monitored. When the infection is affected and the regenerative processes have begun, the tooth is filled and finished (with a crown or only with a filling). There are cases when the granuloma does not respond to such treatment and surgery should be resorted to. In it, the granulation tissue and part of the tip of the tooth are removed by micro-invasive surgery – apical osteotomy. This is a conservative surgical method in which the tooth is preserved in the patient’s mouth. The third, most unfavorable method is when the tooth needs to be extracted.

Cariesology

The dental cavity is a pathological process which proceeds with demineralization and destruction of the strong teeth tissues. As a result of its development the dental morphology, the occlusal relations, the integrity of the dentition are disturbed. In some cases a damage to your chewing ability may be inflicted or even your aesthetic look.

The initial stage of the carious lesion is reversible, in fact a treatment can be initiated. When some of the terms of your oral environment are changed the process of demineralization can be stopped therefore remineralization can occur. Therefore, early diagnosis of caries allows for non-invasive preventive treatment (without stuffing and obturation of the cavity).

In advanced case of cavity a routine conservative treatment is applied – the carious mass is removed and obturated (a sealant is placed)