Endodontics is a specialty of dental surgery that treats diseases of the interior of the tooth; “endo” meaning “interior” in Greek and “dont” meaning “tooth”. When a cavity penetrates deep into the dentin, the tooth becomes infected. Bacteria colonize the tooth tissue and can reach the pulp.
If nothing is done, the pulp will become necrotic and the space that contains it (the endodontium) will become infected. The tooth then becomes a reservoir of bacteria. These bacteria colonize the entire root system, even the alveolar bone. The micro-organisms will then generate an inflammatory reaction of varying degrees, such as abscesses. These lesions are not always felt by the patient. They will lead to a more or less significant destruction of the alveolar bone. This can be diagnosed during radiographic examinations.
Endodontics helps manage all of these pathological situations.
Pulp capping helps to prevent pulp infections.
And when the endodontium is infected, the endodontic treatment enables the maximum elimination of bacteria and supports the acceptance of the infected tooth by the body.
An Endodontist is a dental surgeon who has chosen to practice only this discipline. To become an endodontist, you must study dental surgery and then specialize. A complex technical platform is essential (microscope, microdentistry and microsurgery instruments, ultrasound, 3D scanner…).
The goal of pulp capping is to preserve the pulp of the tooth. Removing the decay with a microscope allows the maximum preservation of healthy tissue. The pulp will then be capped with a specialized material to keep it alive. The tooth will then be reconstructed by the treating dental surgeon.
When bacteria colonize the inside of the tooth, endodontic treatment is required. The canals are disinfected according to a precise protocol. The endodontium is then filled to ensure the sustainability of the disinfection. Once the canals are filled and sealed, a temporary dressing is applied. The tooth will be restored by the treating dental surgeon.
Even if the tooth has already been treated, it can become reinfected. The older the treatment, the greater the risk. Sometimes inadequate cleaning during the initial endodontic treatment can explain why a tooth becomes reinfected. Endodontic treatment must also be repeated when a new prosthetic project is intended (e.g. restoration of a crown or a bridge). In these situations, endodontic treatment must be repeated.
Endodontic microsurgery is indicated when endodontic retreatment is impossible. This is the case when a crown cannot be placed or when retreatment has not resolved the infection. It consists of eliminating the infection by a surgical approach, then disinfecting the tooth again but this time through the root (retrograde treatment) and not through the dental crown (orthograde treatment).