Obtaining treatments for diseased teeth.
Root canal treatment
Endodontics refers to the treatment of unhealthy dental pulp or the unhealthy nerve of a tooth caused, for example, by a deep cavity. In this specialized branch of dentistry, a virtual paradigm shift has occurred over the last 15 to 20 years. Significant new developments in materials, techniques and processes have given new meaning to a procedure that was quite unpopular among both dentists and patients, namely root canal treatment.
Long-term preventive dentistry accomplished with gentle procedures is the aim of all of the dental treatment we provide at our Oberursel Dental Practice.
SPECIALTY TRAINING IN ENDODONTICS
The additional title “Specialty Training in Endodontics” may be used by dentists who have completed continuing education according to the standards and guidelines issued by the Land of Hessen (LZKH), have outstanding expertise in this field and are committed to continuing further education.
ROOT CANAL TREATMENT BY DR. HEINLEIN IN OUR PRACTICE
In the case of a root canal, it is a matter of deciding whether or not it will lead to positive results. It is the last chance for saving a tooth, which is what makes it so important for the procedure to be performed carefully and at a high level of quality. High-quality treatment requires time, and we make sure to have plenty of it. Exceptionally flexible file systems now make it possible for us to clean and disinfect canals with pronounced curvatures that would not have been accessible with a steel instrument. A latex sheet is used to isolate the tooth from bacteria in the saliva and special solutions are used to disinfect the root canal system from the inside. We then fill the tooth with warm gutta-percha using a vertical condensation technique, which is a method from the US. The advantage offered by this method compared to conventional methods is that the liquid, warm gutta-percha in combination with a paste hermetically seals even the finest of branches, which in turn helps to prevent renewed infection of the root canal.
These methods require time and extensive experience, yet are very much worth it when compared to conventional methods, as the resulting prognosis for the tooth is far superior. Because root canal treatment is the last attempt to save a tooth, no shortcuts should be made in the procedure. We would be happy to advise you about your options if a root canal treatment is necessary!
ENDOMETRIC DETERMINATION OF ROOT CANAL LENGTH
A decisive factor in the success of root canal treatment is for the entire length of the root canal to be cleaned and disinfected and then filled. We use endometric measurements to determine the end point of the canal, also known as the apical constriction, with exceptional precision. Because these measurements are often so precise, we are able to eliminate the exposure to frequent radiation from x-rays otherwise used to determine the root length.
ULTRASONIC IRRIGATION AND DISINFECTION PLUS ROOT CANAL CLEANING WITH AN ULTRA-FLEXIBLE FILE SYSTEM
The fundamental and second step in root canal treatment is to clean and disinfect the infected root canal system. We do so by using modern, flexible files as well as heated irrigation solutions that are particularly efficient at destroying the infected tissue due to ultrasonic activation. For your protection and to keep bacteria in the saliva from entering the tooth, we protect the tooth with a latex sheet known as a rubber dam. Thanks to the extremely flexible instruments now available, it is possible to thoroughly clean root canals that are narrow or have pronounced curves.
THERMOPLASTIC ROOT FILLING WITH WARM GUTTA-PERCHA
The last step in root canal treatment is the thermoplastic root filling. We perform this step according to what is called the Schilder technique in which warm gutta-percha, a kind of natural rubber, is vertically condensed, meaning that it is transported into the root canal system while being simultaneously compacted. The advantage offered by this method originating from the US is that the complete hollow area in the root canal system, which is comparable to the root system of a tree, is sealed from the inside. Conventional methods, for example filling with cold gutta-percha, are only able to fill up the main canals. It is only with warm gutta-percha in combination with a free-flowing paste that the material is able to flow into the horizontal branches and finest branches to hermetically seal them. The degree to which the root canal filling is able to fill and seal all of the hollows in the root canal system determines the long-term success of the treatment and the resulting prognosis for the tooth. Because a root canal treatment is the last attempt to save a tooth as already mentioned above, particular care should be taken in such a case.
Teeth that are treated according to the principles mentioned above generally have a good prognosis. If a root canal treatment has already been performed on a tooth and it becomes reinfected, it is possible to perform what is known as retreatment, or root canal revision. It should therefore carefully be considered as to whether the treatment has prospects of success or not. If the prospects are positive, the old root canal filling is removed. The root canal is then cleaned, disinfected and refilled according to the methods mentioned above.
We generally recommend placing a crown or bonded restoration on a tooth that has undergone root canal treatment, as these teeth are at a greater risk of breaking due to the lack of support from horizontal structure.
“WALKING BLEACH TECHNIQUE“ | INTERNAL BLEACHING
The discoloration of teeth is familiar to many. It can be linked to different external factors that affect the teeth. While the classic, well-known type of bleaching can be used to treat external stains to achieve the desired results, a tooth may also suffer discoloration from the inside after a root canal treatment.
The methods we use in the practice generally do not lead to discoloration inside of a tooth. Yet for patients who have had root canals in the past and suffer from discoloration from the inside of the tooth, we offer what is known as the “walking bleach technique” or internal bleaching. In some cases after a nerve has been removed, discoloration may result from the breakdown of blood or proteins or from decomposed tooth pulp inside the tooth that leaves dark discoloration on the inside. This discoloration is not caused by conventional materials, nor is it due to a lack of oral hygiene, and can generally be removed with internal bleaching.
To achieve satisfactory results, a hole is made in the tooth again. The interior of the tooth is filled with a bleaching agent/bleaching gel, and the tooth is then temporarily sealed. After the desired bleaching results have been achieved, Dr. Heinlein removes the bleaching agent and the temporary filling is replaced with a biocompatible, permanent filling. The “walking bleach technique” as a remedy for discoloration may only be used on teeth in which the nerve has been removed during a root canal treatment.