ROOT CANAL TREATMENT (RCT) OF A TOOTH

A root canal is the anatomic space within the root of a tooth. Part of a naturally occurring space within a tooth, it consists of the pulp chamber (within the coronal part of the tooth), the main canal(s), and more intricate anatomical branches that may connect the root canals to each other or to the surface of the root.

Dental pulp

Procedures for root canal

The space inside the root canals is filled with a highly vascularized, loose connective tissue, the dental pulp. The dental pulp is the tissue of which the dentin portion of the tooth is composed. The dental pulp helps complete formation of the secondary teeth (adult teeth) one to two years after eruption into the mouth. The dental pulp also nourishes and hydrates the tooth structure, making the tooth more resilient, less brittle and less prone to fracture from chewing hard foods. Additionally, the dental pulp provides a hot and cold sensory function.

The nerves in your teeth serve only in a sensory capacity. They let you know if something is cold or warm. Since they serve no other function, they can be removed without compromising the tooth. The teeth located around the tooth in question have more than enough sensitivity to tell your brain whether something you've eaten is hot or cold.

Root canal is also a colloquial term for a dental operation, endodontic therapy, wherein the pulp is cleaned out, the space disinfected and then filled.

Root canal anatomy

Root canal anatomy consists of the pulp chamber and root canals. Both contain the dental pulp. The smaller branches, referred to as accessory canals, are most frequently found near the root end (apex), but may be encountered anywhere along the root length. The total number of root canals per tooth depends on the number of the tooth roots ranging from one to four, five or more in some cases. Sometimes there are more than one root canal per root. Some teeth have a more variable internal anatomy than others. An unusual root canal shape, complex branching (especially the existence of horizontal branches), and multiple root canals are considered as the main causes of root canal treatment failures.^[1] (e.g. If a secondary root canal goes unnoticed by the dentist and is not cleaned and sealed, it will remain infected, causing the root canal therapy to fail).

Root canal(s) versus root canal system

The specific features and complexity of the internal anatomy of the teeth have been thoroughly studied. Using a replica technique on thousands of teeth, Hess made clear as early as 1917 that the internal space of dental roots is often a complex system composed of a central area (root canals with round, oval or irregular cross-sectional shape) and lateral parts (fins, anastomoses and accessory canals). In fact, this lateral component may represent a relatively large volume, which challenges the cleaning phase of the instrumentation procedure in that tissue remnants of the vital or necrotic pulp as well as infectious elements are not easily removed in these areas. Thus, the image of root canals having a smooth, conical shape is generally too idealistic and underestimates the limited reach of root canal instrumentation.

Infection of tooth 

The pulp is made up of soft tissue that includes nerves and blood vessels. If bacteria infect the pulp, it will begin to die. After this, the bacteria can increase in number. The bacteria and the substances they release will eventually pass out of the end of the root canal through the small hole where the blood vessels and nerves enter.

This process continues as there is nothing to stop more bacteria passing down the root canal, which causes the tissues around the end of the tooth to become red and swollen. This can cause your tooth to become painful and, in extreme circumstances, your face may become swollen (dental abscess).

Procedure of RCT

1.  A Deep Infection Root canal treatment is needed when an injury or a large cavity damages the tooth'sroot. The root becomes infected or inflamed.

2.  A Route to the Root The dentist numbs the tooth. An opening is made through the crown of the tooth to thepulp chamber.

3.  Removing the Infected/Inflamed Tissue Special files are used to clean the infection and unhealthy pulp out of the canals. Then they shape the canals for the filling material. Irrigation is used to help clean the canals and remove debris.

4.  Filling the Canals The canals are filled with a permanent material. Typically this is done with a material known as gutta-percha. This helps to keep the canals free of infection or contamination.

5.  Rebuilding the Tooth A temporary filling material is placed on top of the gutta-percha to seal the opening. The filling remains until the tooth receives a permanent filling or a crown. A crown, sometimes called a cap, looks like a natural tooth. It is placed over the top of the tooth.

6.  Extra Support In some cases, a post is placed into the root next to the gutta-percha. This gives the crown more support.

7.  The Crowning Touch The crown is cemented into place. Courtesy: Colgate Wikipedia