Cleaning of canal: how to clean dental channels
Cleaning of canals is carried out by dentists for a variety of reasons. A channel is a cavity inside the root. It is filled with a soft loose cloth — pulp, permeated with blood vessels and nerve endings surrounded by connective fibers.
Each tooth provided with a root, which helps him stay in the hole of the alveolar gingiva. In the roots, as said, there are nerve canals. The source of the pain become inflammation they with nerve fibers. The root goes in the outer, external part of the tooth — the crown, which is enamel coated. The tooth consists of 70% bone and hard tissue — dentin. In the centre there is a cavity with pulp that goes in the root channels. Due to her tooth receives nourishment, updated. Teeth can be several roots of it individually. The incisors usually 1, molars 3 and 4.
Indications for cleaning
Often before conducting certain dental procedures there is a necessity of cleaning of the channels. Patients usually are afraid of this, because despite the anesthesia, the discomfort remains. Mostly because of the cleaning of canals and drill many people avoid visiting the dentist until recently. Pulp, due to its looseness and humidity is the perfect breeding ground for germs if they get there. The inflammation and the destruction of the teeth from the inside, even if no external manifestations. The pulp is necrotic the first. And cleaning of the tooth in such cases is the only means of salvation. Infection of the pulp can occur when caries, if the tooth has a hole (hollow), with gingivitis and periodontitis. Cleaning is required for prosthetics, to avoid internal inflammation of the tooth in the future.
Cleaning of canals is necessary if:
- the gums near the tooth is bleeding, swollen and sore;
- on the gums appeared a festering boil (it manifests a taste of pus in the mouth);
- x-ray findings show necrosis of the pulp
- after injuries of the tooth pulp has been damaged;
- tooth decay moved to the inner part of the tooth is called pulpitis, which is manifested throbbing and aching pain, sensitivity to temperature changes.
If the infection went down even further to the root and damaged bone tissue, develops periodontitis — pain and swelling (gumboil). Therefore it is better to treat the tooth immediately, at the first reactions to sweet and sour, then you can stop the process in the hard tissues and cleaning is not required. Cleaning root canal — the procedure is quite complex, although frequent. The doctor has to work blind, the visual channel is not defined.
The cleaning procedure
How to clean the channels? In order to do quality endodontics, a specialist must first determine the length of the root. With this aim, made sure the x-rays. The depth of the canal shall be determined by apex locator, which will show at what depth included tool. The procedure consists of several stages:
- Examination and x-rays.
- Local anesthesia administration.
- Isolation of the tooth is overlaid with the special rubber, which isolates the tooth from the neighbors. Rubber pad (rubber dam) is perfectly safe and will protect the mouth from contact with the disinfecting solution, can cause burns of mucous. The cofferdam will not get into the cleansed channels the saliva.
- Then, a drilling of the tooth to gain access to the channel.
- With the help of special tools (files) the doctor performs a cleaning. Files like a twisted needle, but they are flexible and very durable. Motion vkruchivayutsya, after extracting a single instrument, inserted another, larger diameter. They seem to wind on itself the affected pulp, cleaning the canal walls. This is done until until the whole fabric will not be extracted. The pulp is removed along with the nerve, so after cleaning, in many patients, the teeth no longer hurt.
- After the doctor cleaned the channel from the pulp, to secure the result of a chemical treatment to remove even the remaining particles. Apply antiseptic — 3 or 5% sodium hypochlorite, which will dissolve all the remnants. To enter this composition in the most secluded places helps ultrasonic tip. It creates in the cavity of the tooth vortex flow of the disinfecting solution.
- When the doctor cleaned out the root from the remnants of the pulp, the canal is dried and a filling. The material is a special paste or medical cement. Sometimes, instead of filling the doctor can set the pins. To exclude complications, the doctor after sealing appoints repeated x-rays of the tooth.
In Soviet times, before cleaning the teeth killed the nerve with arsenic. Today, anesthesia allows for processing immediately. Clean channels are pretty long: 1 session lasts 1-2 hours. Sometimes it is necessary to visit the doctor 2-3 times, depending on the complexity of the case.
Stages of filling
Filling material should be as durable, environmentally safe, does not cause allergies, do not be afraid of temperature difference and skip the x-rays. Prior to sealing is necessary to accurately measure the length of the cleaned channels. If this is not done, they will neoprobirovannye and can form cysts, abscesses will develop gingivitis, periodontitis. If pereplanirovat, the patient will be prolonged pain and neuralgia. Length is measured by the apex locator and the depth of the dip is fixed on the monitor. To be safe is x-rayed the tooth directly with the channels tools. Next, prepare the filling for this it is subjected to mechanical processing. Tooth channels and several are expanded to create a cavity for the material of the seal, removes all roughness and bumps, and narrowing the gaps over the entire length, which is important for seeding. This procedure is unpleasant, in spite of a remote nerve.
If earlier the process was carried out manually, it is now used endodontic tips which set of titanium microinstruments. They have a sharpened edge and they, revolving in the channel, gently remove the chip from the walls. This operation is costly, but safe and effective. The extended channel is processed antiseptic. And then comes the last stage is the actual sealing. Often, this is done using the material gutta-percha.
The filling is also different. Do not seal up the channels method one paste which gradually hardens. This method is deprecated and unsafe, because in 90% of cases gives complications, which fears any dentist.
Method one pin different. In addition to the paste is introduced gutta-percha pin. This is more efficient but unreliable. The best variation — system Termofil — it is filling, viscous when heated gutta percha cools and solidifies in the channel at once. This method is expensive. The most frequently used method of lateral condensation of cold gutta-percha. Its essence is that the canal is filled with gutta-percha pins (they can be up to 12) in combination with hardening sealer. The method is inexpensive, effective, no complications gives the channel to the top is completely filled. First, put temporary filling. Simultaneous filling of the root canal and crown in one session prohibited security measures.
What to do after the cleaning
Cleaning of canals is carried out only in a dentist’s office. After the procedure the wall of the tooth remain thinned and respond to any aggressive action. In this regard, the patient side have to spare, to chew on it should not be within 10 days. This requirement must be done before the full completion of the treatment. Otherwise, to go through the whole procedure will have to reconnect. After the anesthesia wears off, the tooth may continue to hurt for weeks. With each passing day the pain should decrease. For pain you can take analgesics in tablets to make the bath tooth decoctions of herbs. Sometimes the process may be delayed another week. The 3rd week the pain should completely go. If the pain after the first 2 days increased, this suggests that there is an infection and gaseous products of its activity began to put pressure on the bone.
If the pain continues, then we are talking about the complications. They can do the following:
- The most common reason — material for sealing has gone beyond the root and puts pressure on the surrounding tissue. The cause may be the incorrect definition of the length of the channel or the wrong choice of pin. The reason can only be seen on x-ray.
- Because of the wide opening in the canal at the root apex occurred antiseptics chemical burn of the surrounding tissue.
- If the channels were not sealed until the end, pain appears when biting. It may also occur within months, while in the remaining cavity will not develop pathogenic microflora. Then there are cysts, granulomas and fistulas.
- The channel remained Outlook tools. Since we are talking about the UV dose, the doctor may not notice the defect. Damage to the instrument may occur due to too much pressure on him, wrong tilt, lack of lubricant, with the wear.
- Perforation of the root. Its block of calcium compound.
- Allergic to materials — be a sharp pain, cheek swelling, gum swelling, analgesics do not work. It is the fault of the doctor who didn’t check a patient’s Allergy. Retreatment is produced with material of a completely different composition.
- The infection has penetrated beyond the channel in the bone. There is a new inflammation — often is to blame the patient. In such cases, you may develop abscess or even osteomyelitis.
Sometimes after washing the doctor may not be sealed from the root, and leave it open so that the decay products had access to the exit. At home recommended frequent rinsing in hypertonic solution of salt or sodium, intake of analgesics. You need to follow, to the meal the hole in the tooth is not clogged with food, plug with a cotton ball.
Under the new inflammation, the doctor may:
- assign physiotherapy;
- spend antibacterial therapy;
- to open the channels and re-clean them;
- to cut a gums under anesthesia for the evacuation of its contents;
- trim the inflammation of the apex of the root.
Complications after cleaning the channels are quite rare, but complete safety cannot be guaranteed. Sometimes during the procedure the tooth is not possible to keep and it should be removed. After cleaning the channels it is necessary to preserve the tooth. Cleaning done carefully to stop Smoking before the end of treatment, strengthen the immune system. Despite all the difficulties, the procedure for cleaning of channels required to save the tooth.