Implantologia

What is endodontics?

Endodontics is a branch of conservative dentistry that focuses on disorders of the tooth pulp and periapical tissues. Endodontic treatment is commonly referred to as root canal treatment. Its essence is:

• pulp cleaning of the dental canals,
• decontamination,
• widening,
• filling with a special substance.

Over the years, endodontic treatment has acquired pejorative connotations due to the painfulness of the methods once used and the length of the procedure, or rather series of procedures, while being moderately effective. Today, endodontics is increasingly based on modern techniques. In well-equipped surgeries, treatments are carried out using a microscope, under effective local anaesthesia, with only rare recourse to devitalisation, i.e. so-called tooth poisoning.

When is endodontic treatment necessary?
Indications for endodontic treatment include certain conditions, most notably pulp gangrene, which is the decomposition of the pulp by anaerobic rotting bacteria, causing inflammation and necrosis as well as the production of foul-smelling gases and a bitter taste in the mouth. If ignored, gangrene causes inflammation of the so-called periapical tissue, making treatment even longer and more difficult. The cause of gangrene is most often advanced carious lesions. It can also be caused by mechanical damage to the tooth (fracture, dislocation), improper filling of the canals during previous endodontic treatment or leaving tool fragments in the canals during preparation.

What does endodontic treatment look like step by step?
Until recently, endodontic treatment absolutely involved devitalization, i.e. chemical poisoning of the dental pulp. The killing of the pulp during the first visit was to enable it to be extracted during the following visit. Today, this type of treatment is a thing of the past. With the help of effective local anaesthetics, often applied by computer, it is possible to remove the pulp without poisoning it first, which significantly shortens the treatment process. So nowadays, the dentist administers anaesthesia and uncovers the tooth with a dental drill, then uses miniature penetrating and sawing tools to select the pulp and widen the canals, and finally, after disinfecting, fills them with so-called gutta-percha, a hardening mass used in dentistry. The final step is to place a filling on the healed tooth.

What is microscopic endodontics?
More effective anaesthesia than in the past is not the only innovation in endodontic treatment. Equally groundbreaking has been the use of advanced optics. Today, more and more surgeries are offering endodontic treatment under the microscope. In medical terms, the essence of the treatment remains the same, but the use of a microscope allows for much greater precision. The equipment, costing tens of thousands of zlotys, allows up to 25-fold magnification and the possibility to work in a treatment field measuring 1×1 mm. This allows the structure of the canals, especially the accessory canals, to be seen in detail, along with their branches and the identification of possible perforations and other damage. The microscope considerably facilitates the so-called preparation of narrow, winding and atypical areas, especially in combination with a so-called endometer, i.e. a device for measuring the depth of the canals.

How much does endodontic treatment cost?
Endodontic treatment, especially with the use of a microscope, is very effective and, in many cases formerly eligible for extraction, keeps the tooth in the mouth for years to come. However, this type of treatment is not cheap. While for a standard preparation and filling of a cavity we pay 200-300 PLN, the necessity of root canal treatment increases the cost at least twice. If we decide on endodontic treatment with the use of a microscope, depending on the number of canals in the tooth and the complexity of their anatomical structure, we will pay from 500 to 1500 zł. Sometimes, dental surgeries offer root canal treatment "from as little as" 250 or 300 zł, but usually these prices apply only in simple cases and do not include the cost of a dental consultation (about 100 zł).