When tooth pulp (containing nerves, arterioles, venules, lymphatic tissue, and fibrous tissue) is exposed either because of decay or of a trauma or when it is affected by pulpitis (common, painful toothache), it eventually becomes necrotic.
Bacteria and decomposition by-products, through the apical foramen connecting the dental pulp to the tooth root, cause the inflammation of the periodontic bone surrounding the tooth root apex (called periapex). In order to relieve pain and to conserve the affected tooth, endodontic treatment (root canal therapy or devitalization) is necessary. Proper root canal treatment may be necessary to treat periapical lesions (cysts and granulomas) resulting from previous inappropriate treatment or pre-existing nonsymptomatic lesions.
Treatment generally involves three phases, whereby each stage is preparatory for the next one:
-First an opening in the crown of the tooth is made. Very small instruments called ‘files’are used to clean the pulp from the pulp chamber and root canals, and to shape the space for filling. In order to understand whether the canal has been completely cleaned, Dr Adis uses x-rays. Root canal shaping is a fundamental step in the procedure whereby canals undergo irragtion and antibacterial medications (bleach-based disinfectants) and are subsequently sealed. New nickel-titanium instruments are used today, which are more flexible and durable.These instruments, after the canal is funnelled via manual instruments for tapering can be used in a rotational motion. They are sufficient for shaping the canal in a few steps and do not require the use of too many instruments. Consequently, except for extremely complex cases, mechanincal root canal shaping does not require long and numerous visits.
Subsequently, bacteria and damaged pulp are cleaned through irrigation detergents which remove necrotic tissues and debris, leaving the canals clean and ready for filling.
-Once the canals are clean, Dr. Adis fills them with a special medication and then applies a temporary filling to close the opening. Once pain and discomfort disappear, the third and final step of the therapy can be carried out.
-The last step in root canal therapy consists of sealing the spaces within tooth roots so that bacteria cannot proliferate and breed toxins that may cause periapical lesions such as abscesses (acute infection) and granuloma (chronic infection).
Dr Bahri Adis makes use of gutta-percha (natural rubber) points matching the canal diameter. Gutta-percha points are then moulded to adapt them to the canal shape allowing for accurate, stable and durable obturations.
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