Root Canal Essay, Research Paper
There are different ways a root canal can be performed. Root canal can be started different ways depending on the problem. There can be three situations when a root canal is needed and can be done according to the problem.
A tooth could be injured, but without a filling. The pulp (the area around the top of the root), and the root died, over the years abscess on the apex (the very bottom of the root) of the tooth formed. This could happen like this, lets say that you were punched in the mouth a long time ago, your tooth moved slightly and was sore for a couple of days and then went away. Then ten years later it started to bother you again. Second reason can be a very deep filling and the tooth broke (recently), after the filling was there or split that opened up a deep filling. This could happen because you went jetskiing and weren’t careful, slipped off you jetski and it fell on you knocking a tooth out. Another case can be a case where the filling went to the root of the tooth, the nerve never died – it’s alive but the root canal needs to be done because the filling is too deep and it is irritating the tooth. The third reason is when a tooth had a deep filling for years and now it is irritated by it because the filling is so old. Over time the tooth died slowly and started hurting because of abscess and infection.
Root canal technical procedure for case #1 (The nerve died). In the middle of the tooth, close to pulp, a hole is drilled using dentist’s drill with a small thread. The hole is drilled just to the nerve pulp usually there is no root because of abscess. This procedure is practiced thoroughly in dental school; the dentist doesn’t have room for mistakes here. If the cause of this root canal was abscess, pus maybe coming out. The canal is cleaned and irrigated more. If abscess is present, the root canal is left open for a few days to have all the pus drained. The instruction to the person is to rinse their mouth with hot water as much as possible until the next appointment usually within the next couple of days. The next appointment consists of cleaning the canal more using files which come in different sizes. Each tooth has an approximate size in which a certain file is to be used. A file – is a tool that looks like a needle with plastic holder on top and tread at the tip but it’s much smoother than a broach. After cleaning with the file and the canal is clean without anymore pus it is cleaned with fluoride and water mix. When the canal is clean, a cotton pallet is put in the canal and a temporary filling for another couple of weeks to makes sure there is no more abscess and the disinfecting is good enough to make a permanent filling. In another couple of weeks there is another appointment to finish the root canal. If everything is okay and there isn’t anymore abscess or pus, the canal is cleaned again with the fluoride mixture, filled with cement and natural rubber points, which are called gutta percha. Gutta percha is used to seal root canals, as a temporary filling material. The cement is dipped into the rubber and then inserted into the canal. The excess cement is taken off with special hot instrument called spoon. Then a permanent filling is made which can be a composite or amalgam alloy. Composite fillings are mainly inorganic. The inorganic filler consists of glass particles, fused silica, and quartz crystals. The organic part of the filling is composed of polymers (large organic molecules). The amalgam alloy components are 65% minimum silver, 29% maximum tin, 6%maximum copper, and 2% maximum zinc. In cases where there is more pus and more abscesses, the root canal has to be reopened and cleaned more. In that case the canal is left open and the patient is put on antibiotics.
Root canal technical procedure for case #2. For a fractured tooth, open the pulp, which again is the surrounding or head of the nerve, take out the nerve with broaches. The tool used in this area is a broach- this tool looks like a needle with threads on it. The nerve is about .75 cm – 1.50 cm long and it looks like a thread of peach colored flesh with capillaries of blood. The canals are cleaned and widened to fit a decent amount of cement in them. This is done with files. In this case since the tooth is fractured, and the root was just taken out, there is only a temporary filling made until next appointment. The next time a crown is measured to cover the entire tooth area. The post and cord is used to take the measurements. The post is a piece of platinum wire about 2 cm long and 1 mm in diameter. This piece of metal is inserted into the root canal and attached with cement on the bottom of the canal. On top of the tooth there is about .5 cm of the post sticking out to make a resin composite buildup out of the cord. The cord has the same composition as the composite filling. Which is the structure that you are making on top of the post and around the tooth. On top of it all goes the crown. Sometimes if there is a lot of the tooth lost the structure can be very hard to make. In that case a temporary post and cord are made out of casting wax (waxy material) which is then send to the laboratory to make a permanent post and cord out of metal. This is done very rarely says dental assistant Lesya Didovets from Eastman Dental Center.
Root canal technical procedure for case #3 (Irritated nerve because of an old and deep filling) starts out just like in Procedure #1. After the canal is cleaned for the last time a permanent filling isn’t put in. Instead of a permanent filling a tooth structure is build up using post and cord procedure as described in Procedure #3.