Endodontics in Padua

This brief introduction to dental anatomy is necessary to better understand the role of endodontics.

Endodontics is the branch of dentistry that deals with the root canal treatment (or devitalization) of a tooth whose pulp has been irreversibly damaged by a bacterial infection or trauma. The pulp is the collection of nerves and blood vessels inside a tooth.
Devitalization means the removal of this pulp, along with the cleaning and disinfection of the space it occupied. This process desensitizes the tooth, though it doesn't mean the tooth can't function like a healthy one.

With the right care, a devitalized tooth can still chew normally or even be moved with braces.

So, from the outside, it will look like a perfectly normal tooth, but it won’t feel pain from stimuli such as heat or cold. That might sound like a benefit, but in reality, we have to remember that if Mother Nature gave the tooth nerves and blood vessels, there’s a reason.

Just like any other part of the body, nerve signals and sensitivity are essential for alerting us to external threats.

Let’s say a cavity starts to form on the surface of a tooth. As it gets deeper, you may begin to feel discomfort or pain, perhaps while chewing. If treated in time, the tooth can be saved by removing the cavity and filling it.

However, if there were no pain signals, the decay could continue to spread unnoticed. By the time it becomes extensive, the tooth might break and become very difficult (or impossible) to restore.

Root canal treatment is a meticulous and highly precise process, as it involves working within the microscopic spaces inside the tooth.

As mentioned earlier, the procedure begins with the mechanical removal of the pulp, followed by disinfection using special irrigants to eliminate as many bacteria as possible. To prevent small instruments or unpleasant-tasting solutions from reaching the mouth, the use of a rubber dam is always part of the procedure.

At the end, the cleaned space is sealed with a thermoplastic material that is radiographically visible. The fact that this material can be seen on an X-ray is extremely important to ensure that the treatment has been properly carried out.

This is also essential in the case of retreatment, which means redoing a root canal that may not have been done correctly the first time, often due to a silent infection that has developed afterward.

The duration of root canal therapy depends on the anatomical complexity of the tooth. Not all teeth are the same, each is unique, not just between individuals but even within the same mouth.

Teeth have different numbers of roots that must be cleaned and disinfected.
For example:

• An incisor usually has one root

• A molar generally has three

A more complex tooth may therefore require more than one session to complete.

At our clinic, a root canal is usually started and completed in about an hour, but in more complex cases, it may take 2 to 3 hours, possibly over two separate appointments.

How do you restore a devitalized tooth?

Once a tooth has been correctly devitalized, it must be properly restored so it can resume its chewing function.

To access the root canals and carry out proper endodontic treatment, a portion of the tooth structure often needs to be removed.
Additionally, the tooth that requires a root canal is usually already severely damaged, either by a large cavity or a fracture, which is often why the treatment is needed in the first place.

This means that we must carefully evaluate the remaining tooth structure.
To simplify:

• If, after removing the decay or fractured part, there is enough remaining healthy tooth to support chewing, a simple filling can be done.

• If the tooth is too compromised, it will need a protective cover, which may be an inlay or a dental crown.