Microscopic endodontics refers to root canal treatment with the help of a microscope.
The system of dental root canals is a sophisticated structure of different diameter canals with only a small portion accessible by mechanical cleaning. Thus, a complex treatment must be applied. Bacteria enter root canals and cause inflammation, which leads to the necrosis of dental pulp tissue and lesions in the bone beyond the root canal, i.e. a developing focus of an infection. Using a microscope, a medical professional has a possibility to see and assess the structure and lesions of dental tissues, which is impossible to a naked eye. The treatment process involves removing infected and inflamed dental pulp tissues, carefully cleaning of the canals, disinfection, formation and filling with the specialised material (gutta-percha).
The treatment consists of three key stages:
- Root canal passage. The aim is to find the passage to the very top of the root. This is the most difficult stage of treatment that requires the greatest portion of the time. Sometimes, root canal diameters can be very narrow, ranging from 0.06 mm or 0.08 mm to 0.1 mm. A surgical microscope is required to locate canals of such small diameter. Ultrasound scalers are used to prepare root canals and ensure a precise and meticulous process that conserves the possible majority of dental hard tissues.
- Chemomechanical cleaning of root canals. The aim is to widen the passage maintaining the anatomy of the root canal and prepare the site for medications and the new filling material. This stage involves the use of a flexible machine or manual nickel-titanium instruments that help to remove the remaining impurities as well as old fillings. However, mechanical instruments cannot access all of the root canal systems, and this is where chemical solvents are used for disinfection.
- Root canal filling. The aim is to fill the entire length of the root canal with the filling material. Thermoplastic filling materials are used for this purpose as heat and condensation make them adapt to the complicated anatomy of the canals. This is how the canal system is hermetically sealed and the present focus of inflammation, depending on its size, clears in some months or years.
Endodontically treated tooth must be restored as soon as possible to avoid entry of new bacteria into the root canal system and chipping of the tooth/root. An endodontics professional always works with a team of other dental specialists that can restore the form and function of the tooth by way of filling or prosthesis, depending on the clinical situation.
Good endodontic treatment + rapid and good quality restoration = Good prognosis!
Today, endodontic treatment is no longer painful while results are successful and long-lasting. The success of endodontic treatment is approx. 94 %. Modern technologies and extensive knowledge help to overcome difficult situations, such as curved and calcified canals, removing broken instruments and old filling materials.
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