WHEN DO I NEED IT?
Endodontic treatment, also known as "root canal therapy," is a dental procedure that targets the interior of the tooth. It becomes necessary when bacteria penetrate the interior of the tooth and affect the nerve (pulp), which becomes infected, inflamed, and causes acute pain to the patient. Bacteria can enter through deep decay, a crack, a leakage in an old filling or crown, or as a result of tooth trauma.
Once bacteria enter the interior of the tooth and affect and necrose the nerve, they continue their path and exit through the root, subsequently affecting the jawbone, creating an abscess or cyst in the jaw accompanied by pus or swelling in the patient.
WHAT IS IT?
The purpose of endodontic therapy is to clean and disinfect the internal system of the tooth from the bacteria that have settled. This is achieved using specialized instruments that sanitize and remove the bacteria while shaping the interior of the tooth, which is then sealed to prevent further bacterial ingress. The entire procedure is performed with the assistance of an optical microscope and requires great precision and microsurgical techniques.
At this stage, the endodontic therapy is completed. It is crucial to return to your dentist for the placement of a permanent restoration on the tooth (such as a filling or crown) to protect it and restore its functionality for chewing.
AFTER TREATMENT
The tooth may experience mild post-operative discomfort during chewing for a few days after the root canal treatment, which can be easily managed with over-the-counter painkillers. In very rare cases, approximately in 5% of cases, antibiotics may be needed after the treatment. However, for these rare instances, we maintain continuous communication with our patients and provide appropriate guidance.
AFTERCARE
After endodontic treatment, the tooth gradually returns to its original healthy condition, and once the permanent restoration is placed, you can use it without any discomfort and with safety. In cases where there was a cyst in the jawbone, it is deemed necessary to have a follow-up examination in 6 or 12 months to monitor that the bone has healed, the cyst has disappeared, and the body has created new healthy bone in the jaw.
Often, a tooth may have undergone previous endodontic treatment (root canal treatment) that may have failed, leading to reinfection of the root canals by bacteria. As a result, a cyst may form at the root of the tooth, which can be accompanied by pain or swelling. The re-treatment of endodontic therapy should be performed by an Endodontist who has the appropriate equipment and, with the assistance of a microscope, can predictably remove previous materials, correct previous errors, effectively clean the roots, and seal them with the most modern materials in all dimensions. Subsequently, a temporary filling is placed, and the patient returns to the dentist for permanent restoration.
In most cases, root canal treatment alone is sufficient to save your tooth from extraction. However, there are some cases where simple root canal treatment is not enough to lead to healing, and your Endodontist may recommend surgical intervention, which has been proven to have a 90-100% success rate.
Why do I need microsurgical endodontics?
The reason you need microsurgical intervention is that in some cases of teeth, there are anatomical peculiarities such as nerve bifurcations, hidden nerves, or due to previous treatments, the normal anatomy of the tooth has changed and these areas cannot be properly cleaned with simple endodontic treatment. As a result, bacteria remain in these areas, maintaining inflammation and preventing healing. Also, in a very small percentage, although endodontic treatment has been performed correctly, the size of the cyst may be so large that it does not allow it to heal, necessitating complete removal of the cyst using microsurgery.
How is the microsurgical procedure performed?
First of all, there's no need to worry when you hear the term "microsurgical procedure" because nowadays it's a completely painless process, and the patient doesn't feel any discomfort both during and after the treatment. With the modern tools available in our clinic, such as the three-dimensional cone beam computed tomography (CBCT), dental microscope, ultrasound, and other materials, the procedure can be performed predictably, quickly, with great precision, and success without pain.
In this microsurgical procedure, the Endodontist makes a small incision next to the gums to access the root and remove all pathological tissues, cysts, and bacteria. Then, a small portion (1-3 millimeters) of the root tip is removed, and with the help of special ultrasonic instruments, the tooth is thoroughly cleaned in a retrograde manner. Once the area is completely cleaned, a sealant is applied to the root using the most advanced bio-ceramic biocompatible materials, and some stitches are placed for faster healing of the gums.
All this procedure (apicoectomy and retrograde filling) is performed on in just one session it is very comfortable and tolerable for the patient, performed under local anesthesia, while postoperative symptoms are very mild, and the patient can resume normal activities as early as the next day.
The treatment is called Vital Pulp Treatment, where we can preserve the nerves of the tooth, keeping them alive along with all their functions, thereby avoiding endodontic therapy (root canal treatment). This approach is particularly beneficial for children and teeth whose roots have not yet fully formed, as it allows the teeth to complete their development.
When can we apply vital pulp treatments?
When your tooth hurts momentarily upon drinking cold water (not hot), without spontaneous pain otherwise (i.e., no automatic pain), no swelling, or intense pain upon chewing, we can assess the chances of avoiding endodontic treatment and preserving the nerves in the tooth roots. How is this achieved? If the decay is deep and reaches the nerve, and the above symptoms exist, we can, with the help of dental microscopy, remove only the superficial portion of the affected nerve that does not require complete removal of all nerves. Then we cover the nerves with special, bio-ceramic, biocompatible materials of the latest technology, and the patient returns to the dentist for a simple filling.
This way, we maintain the tooth's health by preserving the nerves and blood vessels internally. The patient retains full sensation of their teeth, completely painlessly and successfully.
As Endodontists, we are called upon to address and treat even the most challenging teeth. The complexity of teeth involves anatomical peculiarities related to the roots, such as large or abrupt curvatures, very narrow and calcified root canals, difficult access to posterior areas of the mouth, or dealing with various types of pathological conditions affecting the tooth.
When we are called upon to manage previous failed endodontic treatments, we need to remove the previous sealing materials from inside the tooth, such as old gutta-percha and other contaminated materials. Many times, we encounter errors from previous treatments such as broken instruments, tooth perforations, alteration of the normal course and anatomy of the root, failure to locate all roots/nerves, which we must correct either conservatively through endodontic retreatment or microsurgically by addressing and resolving the issue externally.
In our clinic, we place special emphasis and care on the management of dental injuries in both children and adults. Dr. Tzimoulas possesses the knowledge and experience, having handled hundreds of dental injury cases in Greece and abroad, to successfully manage and treat injured teeth. Often, interdisciplinary treatment of a serious injury may be necessary, involving collaboration with other specialties (Orthodontist, Pediatric Dentist, Prosthodontist) for the best and most effective management of a case. Additionally, after a dental injury, there is a possibility of potential post-traumatic complications, which Dr. Tzimoulas will explain during the diagnostic appointment and guide you regarding the prognosis of the injured teeth and the need for future treatment. For more information, you can visit the specialized platform for dental injuries at www.dentaltrauma.gr.
Tooth autotransplantation serves as an alternative solution for replacing a lost or irreversibly damaged tooth by transplanting another tooth from a different location within the same patient's mouth. This can occur following severe tooth trauma, particularly in the upper front region, during childhood. Due to the young age of the patient, dental implants may not be suitable in such cases.
For tooth autotransplantation, interdisciplinary evaluation involving an Orthodontist, a Prosthodontist, and an Endodontist is required. Together, they will plan and perform the tooth autotransplantation procedure and the subsequent aesthetic restoration, ensuring that the patient permanently regains a natural tooth in the area of loss instead of a dental implant. The treatment boasts high success rates. For more information, please inquire during your diagnostic appointment.
In some cases, microsurgical treatment is not feasible due to the position or anatomy of the tooth. In these instances, intentional tooth replantation is the last resort for preserving the tooth.
What is intentional replantation?
The tooth is extracted, then the cyst is removed, followed by apicoectomy and retrograde filling, just like in microsurgical technique, but outside the mouth. Subsequently, the tooth is replanted in its original position and immobilized. Postoperative pain is less compared to the microsurgical technique.
The success rate of intentional replantation is very high, over 85% according to recent studies.
Three-dimensional Cone Beam Computed Tomography (CBCT Scan) is one of the most significant innovations in modern dentistry. Our 3D tomography allows us to visualize with exceptional accuracy and quality, and with very low radiation dose, the patient's jaw in three dimensions, assessing the teeth, their roots, and the bone from all angles, providing valuable information about root and nerve anatomy, the presence and extent of cysts, potential internal tooth damage that determines diagnosis, and the precise approach for even better results. Our clinic is equipped with the state-of-the-art three-dimensional cone beam tomograph Morita R100.
In some teeth, following trauma or old endodontic treatments, the tooth may become grayish or darken. This can be corrected by restoring the tooth's natural color using the technique of internal bleaching.
A prerequisite for internal bleaching is to have undergone endodontic treatment (root canal therapy). Subsequently, a special bleaching material is placed inside the tooth, which should remain for several days, and the tooth color is reassessed. Once the tooth has regained its natural color, the permanent filling is placed inside the tooth. The entire procedure is completely painless and does not require anesthesia.
WHEN DO I NEED IT?
Endodontic treatment, also known as "root canal therapy," is a dental procedure that targets the interior of the tooth. It becomes necessary when bacteria penetrate the interior of the tooth and affect the nerve (pulp), which becomes infected, inflamed, and causes acute pain to the patient. Bacteria can enter through deep decay, a crack, a leakage in an old filling or crown, or as a result of tooth trauma.
Once bacteria enter the interior of the tooth and affect and necrose the nerve, they continue their path and exit through the root, subsequently affecting the jawbone, creating an abscess or cyst in the jaw accompanied by pus or swelling in the patient.
WHAT IS IT?
The purpose of endodontic therapy is to clean and disinfect the internal system of the tooth from the bacteria that have settled. This is achieved using specialized instruments that sanitize and remove the bacteria while shaping the interior of the tooth, which is then sealed to prevent further bacterial ingress. The entire procedure is performed with the assistance of an optical microscope and requires great precision and microsurgical techniques.
At this stage, the endodontic therapy is completed. It is crucial to return to your dentist for the placement of a permanent restoration on the tooth (such as a filling or crown) to protect it and restore its functionality for chewing.
AFTER TREATMENT
The tooth may experience mild post-operative discomfort during chewing for a few days after the root canal treatment, which can be easily managed with over-the-counter painkillers. In very rare cases, approximately in 5% of cases, antibiotics may be needed after the treatment. However, for these rare instances, we maintain continuous communication with our patients and provide appropriate guidance.
AFTERCARE
After endodontic treatment, the tooth gradually returns to its original healthy condition, and once the permanent restoration is placed, you can use it without any discomfort and with safety. In cases where there was a cyst in the jawbone, it is deemed necessary to have a follow-up examination in 6 or 12 months to monitor that the bone has healed, the cyst has disappeared, and the body has created new healthy bone in the jaw.
Often, a tooth may have undergone previous endodontic treatment (root canal treatment) that may have failed, leading to reinfection of the root canals by bacteria. As a result, a cyst may form at the root of the tooth, which can be accompanied by pain or swelling. The re-treatment of endodontic therapy should be performed by an Endodontist who has the appropriate equipment and, with the assistance of a microscope, can predictably remove previous materials, correct previous errors, effectively clean the roots, and seal them with the most modern materials in all dimensions. Subsequently, a temporary filling is placed, and the patient returns to the dentist for permanent restoration.
In most cases, root canal treatment alone is sufficient to save your tooth from extraction. However, there are some cases where simple root canal treatment is not enough to lead to healing, and your Endodontist may recommend surgical intervention, which has been proven to have a 90-100% success rate.
Why do I need microsurgical endodontics?
The reason you need microsurgical intervention is that in some cases of teeth, there are anatomical peculiarities such as nerve bifurcations, hidden nerves, or due to previous treatments, the normal anatomy of the tooth has changed and these areas cannot be properly cleaned with simple endodontic treatment. As a result, bacteria remain in these areas, maintaining inflammation and preventing healing. Also, in a very small percentage, although endodontic treatment has been performed correctly, the size of the cyst may be so large that it does not allow it to heal, necessitating complete removal of the cyst using microsurgery.
How is the microsurgical procedure performed?
First of all, there's no need to worry when you hear the term "microsurgical procedure" because nowadays it's a completely painless process, and the patient doesn't feel any discomfort both during and after the treatment. With the modern tools available in our clinic, such as the three-dimensional cone beam computed tomography (CBCT), dental microscope, ultrasound, and other materials, the procedure can be performed predictably, quickly, with great precision, and success without pain.
In this microsurgical procedure, the Endodontist makes a small incision next to the gums to access the root and remove all pathological tissues, cysts, and bacteria. Then, a small portion (1-3 millimeters) of the root tip is removed, and with the help of special ultrasonic instruments, the tooth is thoroughly cleaned in a retrograde manner. Once the area is completely cleaned, a sealant is applied to the root using the most advanced bio-ceramic biocompatible materials, and some stitches are placed for faster healing of the gums.
All this procedure (apicoectomy and retrograde filling) is performed on in just one session it is very comfortable and tolerable for the patient, performed under local anesthesia, while postoperative symptoms are very mild, and the patient can resume normal activities as early as the next day.
The treatment is called Vital Pulp Treatment, where we can preserve the nerves of the tooth, keeping them alive along with all their functions, thereby avoiding endodontic therapy (root canal treatment). This approach is particularly beneficial for children and teeth whose roots have not yet fully formed, as it allows the teeth to complete their development.
When can we apply vital pulp treatments?
When your tooth hurts momentarily upon drinking cold water (not hot), without spontaneous pain otherwise (i.e., no automatic pain), no swelling, or intense pain upon chewing, we can assess the chances of avoiding endodontic treatment and preserving the nerves in the tooth roots. How is this achieved? If the decay is deep and reaches the nerve, and the above symptoms exist, we can, with the help of dental microscopy, remove only the superficial portion of the affected nerve that does not require complete removal of all nerves. Then we cover the nerves with special, bio-ceramic, biocompatible materials of the latest technology, and the patient returns to the dentist for a simple filling.
This way, we maintain the tooth's health by preserving the nerves and blood vessels internally. The patient retains full sensation of their teeth, completely painlessly and successfully.
As Endodontists, we are called upon to address and treat even the most challenging teeth. The complexity of teeth involves anatomical peculiarities related to the roots, such as large or abrupt curvatures, very narrow and calcified root canals, difficult access to posterior areas of the mouth, or dealing with various types of pathological conditions affecting the tooth.
When we are called upon to manage previous failed endodontic treatments, we need to remove the previous sealing materials from inside the tooth, such as old gutta-percha and other contaminated materials. Many times, we encounter errors from previous treatments such as broken instruments, tooth perforations, alteration of the normal course and anatomy of the root, failure to locate all roots/nerves, which we must correct either conservatively through endodontic retreatment or microsurgically by addressing and resolving the issue externally.
In our clinic, we place special emphasis and care on the management of dental injuries in both children and adults. Dr. Tzimoulas possesses the knowledge and experience, having handled hundreds of dental injury cases in Greece and abroad, to successfully manage and treat injured teeth. Often, interdisciplinary treatment of a serious injury may be necessary, involving collaboration with other specialties (Orthodontist, Pediatric Dentist, Prosthodontist) for the best and most effective management of a case. Additionally, after a dental injury, there is a possibility of potential post-traumatic complications, which Dr. Tzimoulas will explain during the diagnostic appointment and guide you regarding the prognosis of the injured teeth and the need for future treatment. For more information, you can visit the specialized platform for dental injuries at www.dentaltrauma.gr.
Tooth autotransplantation serves as an alternative solution for replacing a lost or irreversibly damaged tooth by transplanting another tooth from a different location within the same patient's mouth. This can occur following severe tooth trauma, particularly in the upper front region, during childhood. Due to the young age of the patient, dental implants may not be suitable in such cases.
For tooth autotransplantation, interdisciplinary evaluation involving an Orthodontist, a Prosthodontist, and an Endodontist is required. Together, they will plan and perform the tooth autotransplantation procedure and the subsequent aesthetic restoration, ensuring that the patient permanently regains a natural tooth in the area of loss instead of a dental implant. The treatment boasts high success rates. For more information, please inquire during your diagnostic appointment.
In some cases, microsurgical treatment is not feasible due to the position or anatomy of the tooth. In these instances, intentional tooth replantation is the last resort for preserving the tooth.
What is intentional replantation?
The tooth is extracted, then the cyst is removed, followed by apicoectomy and retrograde filling, just like in microsurgical technique, but outside the mouth. Subsequently, the tooth is replanted in its original position and immobilized. Postoperative pain is less compared to the microsurgical technique.
The success rate of intentional replantation is very high, over 85% according to recent studies.
Three-dimensional Cone Beam Computed Tomography (CBCT Scan) is one of the most significant innovations in modern dentistry. Our 3D tomography allows us to visualize with exceptional accuracy and quality, and with very low radiation dose, the patient's jaw in three dimensions, assessing the teeth, their roots, and the bone from all angles, providing valuable information about root and nerve anatomy, the presence and extent of cysts, potential internal tooth damage that determines diagnosis, and the precise approach for even better results. Our clinic is equipped with the state-of-the-art three-dimensional cone beam tomograph Morita R100.
In some teeth, following trauma or old endodontic treatments, the tooth may become grayish or darken. This can be corrected by restoring the tooth's natural color using the technique of internal bleaching.
A prerequisite for internal bleaching is to have undergone endodontic treatment (root canal therapy). Subsequently, a special bleaching material is placed inside the tooth, which should remain for several days, and the tooth color is reassessed. Once the tooth has regained its natural color, the permanent filling is placed inside the tooth. The entire procedure is completely painless and does not require anesthesia.
