Endodontic Treatment

Endodontic treatment is performed when inflammation or infection affects the internal tissues of a tooth — the pulp and root canals. The procedure eliminates the infection and preserves the tooth.

Root canal treatment is most commonly required in the following situations:

• acute or chronic pulpitis;
• apical periodontitis;
• granuloma or cyst at the root apex;
• dental trauma with pulp involvement;
• preparation of a tooth for a prosthetic restoration.

There are also symptoms that may indicate a problem with the canals and warrant a dental visit: severe or throbbing tooth pain, swelling of the gum or cheek, the development of an abscess (gumboil), tooth darkening, or pain during chewing.

At the same time, there are situations in which endodontic treatment is not performed — for example, if there is a vertical root fracture, the tooth is too severely damaged to be restored, or there is significant periodontal tissue destruction.

The final decision on treatment is always made by the dentist following examination and diagnosis. It is impossible to determine the cause of pain or the condition of the canals independently.

Endodontic treatment is usually carried out over 2–3 appointments. This is because the canals require thorough cleaning and disinfection, and the tooth must be checked for residual infection before permanent filling. This approach makes the treatment safe and long-lasting.

Diagnosis: X-ray and CT Imaging

The procedure begins with diagnosis. The dentist examines the tooth and takes a periapical X-ray; in complex cases, a cone-beam CT scan is performed. The 3D image shows the shape of the canals, their curves, and allows precise treatment planning.

Anaesthesia and Tooth Isolation (Rubber Dam)

Local anaesthesia makes the procedure pain-free. To protect the canals from saliva and bacteria, a rubber dam is used — a thin latex sheet that creates sterile conditions and helps the filling bond more effectively.

Mechanical Preparation of the Canals

At this stage the dentist cleans and shapes the canals to prepare them for filling. A combination of hand and rotary instruments is used. The canals are irrigated with antiseptic solutions such as sodium hypochlorite. Canal length is measured using an apex locator to ensure nothing is missed. Mechanical preparation is one of the key stages of endodontic treatment.

Temporary Filling and Medicament Dressing

After the first appointment, a medicament dressing (often based on calcium hydroxide) is placed in the canal and a temporary filling is applied. This protects the tooth and canals between visits and supports tissue healing.

Permanent Root Canal Obturation

The canals are hermetically filled with gutta-percha using lateral or vertical compaction techniques, or sometimes thermafil. A follow-up X-ray is then taken to confirm that the filling is dense, the correct length, and free of voids.

Tooth Restoration Following Endodontic Treatment

After treatment the tooth becomes more brittle, so restoration is essential. Options include a filling, a post and core with a filling, or a post and core with a crown. The choice depends on the extent of the tooth’s destruction.

This step-by-step approach allows the tooth to be preserved long-term, reduces the risk of reinfection, and ensures the most effective outcome.

A dental operating microscope in modern dentistry is not simply an additional device — it is an essential tool for the most precise and safe root canal treatment. It allows the dentist to see what is invisible to the naked eye: magnification of up to 20–30 times, bright illumination of the working field, and even the ability to record the procedure for review and training. This enables thorough canal cleaning, detection of hidden branches, and control of any complex moment during treatment.

Situations where microscope-assisted endodontic treatment is particularly essential:

• Canal retreatment — when previous treatment has been unsuccessful or inflammation has recurred.
• Narrow or calcified canals — conventional instruments cannot always negotiate such canals without risk of complications.
• Locating hidden or additional canals — some canals may be so small or unusually positioned that they cannot be identified without magnification.
• Removal of a fractured instrument — when part of a file has remained inside the canal, the microscope allows the dentist to work with maximum precision without risking root damage.
• Treatment of root perforations — when the root wall has been damaged, precision is essential to resolve the problem and preserve the tooth.

For straightforward canals a microscope is not always necessary — they can be treated using conventional methods. However, in complex cases its use significantly improves quality, precision, and safety, and reduces the risk of repeat intervention and complications.

Yes, microscope-assisted treatment costs a little more, but it is an investment in the longevity of the tooth and the patient’s peace of mind — high-quality treatment preserves the tooth for many years and avoids the need for additional procedures in the future.