Stages of endodontic treatment

What are endodontic treatments?

Endodontic treatment is known to most people as the "root canal" procedure. It is often viewed as a traumatic, painful procedure that everyone avoids. In recent years, technology has evolved significantly, making the entire root canal procedure much more user-friendly and easier to tolerate. Below, we will present in detail the main steps involved in endodontic treatment.

1. Anesthesia – this is a very important step, especially for the patient's comfort. Dental pulp affected by bacteria is extremely reactive, so without careful and correct anesthesia, we cannot work under acceptable conditions.

2. Isolation of teeth – on which endodontic treatments are to be performed. For this purpose, a dam is used. The dam is a rubber sheet with a hole through which the tooth will emerge. The rubber sheet is fixed to the tooth with a metal clamp. When it is applied, the patient may feel slight pressure, but will get used to it within a minute. This isolation prevents saliva from entering the tooth, which is particularly important because saliva contains the highest amount of bacteria. Also, the solutions used by the dentist for washing, which are quite strong, will remain on the foil, thus preventing them from coming into contact with the oral mucosa.

3. Accessing the nerve chamber – this stage of endodontic treatment is usually achieved by cleaning the complicated caries that caused the pulp pathology. There are situations where the tooth is severely damaged, and in these cases, the missing walls must be reconstructed before the actual treatment. 

4. Repair and treatment of root canals – the openings of the root canals are exposed using a dental microscope and, if there are calcifications at this level that make it impossible to negotiate them, ultrasonic or diamond-tipped files are used to remove these obstructions.

5. Mechanical treatment of the canals or their widening – initially performed manually, with needles, for initial permeabilization. The correct working length is determined using an apex locator. Then, using rotary systems, the canals are widened accordingly. At this point, the patient may feel a vibration sensation caused by the movement of the rotary needle. The mechanical treatment is associated with appropriate canal irrigation to progressively remove organic and inorganic debris from this level. For endodontic treatments, the most commonly used are sodium hypochlorite and EDTA (ethylenediaminetetraacetic acid).

6. Drying the canals using paper cones – next, the canals will be sterilized using a diode laser. Using a tip of appropriate length, each canal is penetrated and circular movements are performed from the tip of the canal to its opening at the pulp chamber floor for 20-45 seconds for each canal. In cases where there is abundant secretion in the canals, these movements are performed in the presence of sodium hypochlorite and then the root canals are dried using paper cones. However, if there is persistent secretion in the canals, it is necessary to apply a medication to the canals for 7 days to combat it. The most commonly used is calcium hydroxide. This means that, in endodontic treatments, an additional session is required to complete them.

7. Root canal filling – First, the canal walls are coated with canal paste using a paper cone, then gutta-percha points are inserted into each canal and cut at their opening or cut much deeper, and then gutta-percha injection is used. Finally, the crown is filled with composite.

These endodontic treatments are lengthy procedures that require patience and meticulous execution, which is why it is important for the patient to be aware of and understand these stages in order to tolerate and accept root canal filling more easily.

If you need root canal treatment, you can make an appointment online or by calling +40.318.282.274