A root canal is a treatment of the pulp of the tooth that is infected, inflamed, or dead. The dental pulp is a soft substance in the center of the tooth that consists of the blood vessels, nerve, and connective tissue. and this is connected to the surrounding tissue of the tooth. Some roots have more than one root canal, but all have at least one canal.
The first step is to Examine the x-ray of the teeth to see the extent of the decay and infection. If it involved the center core of the tooth called pulp the patient require root canal treatment. The first step is to give local anesthesia to numb the tooth and the surrounding area of the tooth.
Once the tooth is numb, the second step is the removal of the damaged area of teeth and infected pulp.
This is followed by disinfection and shaping of pulp canals using small instruments. Once the infected pulp is cleared out then shaping of the canal.
Clean and disinfected canals are then sealed and filled with an inert biocompatible medicated material known as Gutta-Percha and core portion is filled with a restorative material.
Then the core portion of the teeth is covered by crown placement.
If there is not adequate crown structure, a post is placed into the root next to the gutta-percha. This gives the crown more support.
Why is a root canal necessary?
1. Deep cavity: when the decay extends beyond enamel, dentin and touches the pulp patient suffer from continues and radiating pain.
2. An abscess (infection): The vacant space filled with pus is called abscess, at that time the pulp of the tooth is necrotic and infected with bacteria and all this necrotic tissue collected below the root form pus. Sometimes swelling will be there or patient feels like a mild swelling on the gum from where pus is coming out.
An abscess that is left untreated will continue to infect the bone around the root of the tooth. It may spread into surrounding bone and tissues.
3. Trauma: If a tooth is hit with great force, the nerve of the tooth dies. This could happen immediately after the traumatic accident, or it may happen over many years following the trauma.
4. Fracture: If the fracture extends to the pulpit require root canal treatment. if there is not too much tooth structure left above the gum line for the crown then post is required to retain the restoration.
5. Root Resorption: In the case of root resorption also root canal is required.
Two types of root resorption are there,
a) Defect starts from outside of the root and goes inward called external resorption
b) Defect start from middle or inside of the tooth and goes outward called internal resorption.
Resorption occurs as a reaction to injury, trauma, tooth replantation or aggressive tooth movement during orthodontics.
Resorption usually causes no pain and its diagnosed using x-rays
Resorption defect is typically repaired with a mineral trioxide aggregate(MTA).