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Endodontics
Endodontics
The endodontic space within a tooth contains the dental pulp, which is composed of blood vessels, nerves, odontoblasts, and stellate cells. The branch of dentistry that deals with the physiology and pathology of the endodontium is called endodontics.
Neglected cavities or trauma can lead to the degeneration of the dental pulp, which may become inflamed and eventually necrotic. The most pronounced symptom in such cases is pain. In these situations, devitalization is required—a procedure that removes the vital tissue from the tooth, rendering it a non-vital (or “dead”) tooth.
Endodontic therapy consists of three phases: diagnostic, preparatory, and filling. In the diagnostic phase, the presence of pulp necrosis is assessed, its causes are investigated, and a treatment plan is determined. During this phase, the dentist performs several tests to evaluate inflammation, including a thermal test (to check the pulp’s response to temperature stimuli), palpation, or an electric test.
A panoramic X-ray provides essential information to the dentist, enabling the diagnosis of endodontic lesions and related pathologies, as well as monitoring the success of canal therapy. Once the diagnosis is established, the preparatory phase begins, during which the pulp chamber is accessed, and the root canal is shaped and cleaned. Nickel-titanium instruments are used for shaping, initially manually and then with an electric drill.
Once the root canals are perfectly shaped, they are disinfected—most commonly with sodium hypochlorite, which eliminates bacteria and pulp residues.
One of the most important instruments in endodontics for isolating the treated tooth, preventing contamination of the root canals with saliva (and avoiding the ingestion of disinfectants), is the rubber dam, which is highly recommended during devitalization procedures.
The canals, once perfectly shaped and disinfected, are filled with gutta-percha, a thermoplastic, fully biocompatible, and inert material.
