Temporary tooth filling during endodontic treatment

• When is root canal filling indicated?
• What are the purposes of temporary filling?
• What material should be used for temporary filling?
• How does filling occur?
• What does pain after filling mean?
• Types of fillings
• Types of pastes
• How much does temporary root canal filling cost?

The period for which a temporary filling is placed is determined by the attending physician.
In most cases, a drug that has a long shelf life is placed under the filling material. After this period, the doctor removes the temporary material. When medicinal pastes are used together with disinfectants and antiseptic medications, there is a significant increase in the effectiveness of treatment. In addition, there will be no cross-contamination of soft and hard tissues between visits to the doctor.

When is root canal filling indicated?

There are general indications for the procedure:

• The root canal is affected. This happens if the patient has a chronic form of pulpitis.
• During the purulent stage of pulpitis, regardless of whether the tooth cavity is closed/open.
• If intraradicular soft tissues are excessively affected.

After mechanical processing is completed, a funnel-shaped channel is formed. It has a minimum diameter at the apex, and a minimum at the mouth. Also, the balance between the “diameter and wall thickness” of the channel is observed.

Methods of treatment of dental canals

In dental practice, there are two main methods of treating tooth root canals:

Therapeutic (biological), in which the entire pulp or part is preserved. A drug with a medicinal effect is placed into the dental cavity, which separates the pulp from the temporarily installed filling material. Also, medications can penetrate through dentin from dressings with an antibacterial drug. The effectiveness of drug therapy appears only at the very beginning of inflammation.

Surgical (pulp extirpation) - removal of all pulp from the canals, cleaning, processing and dense filling of the canals. The canals are treated using one of the possible methods:

• Standard filling is the introduction of a paste-like material into the root canal cavity;
• Vertical condensation method - by compacting gutta-percha in a filling paste;
• Filling with thermophile - hot gutta-percha is placed on the obturator and fills all branches.

Sometimes, for endodontic intervention, it is advisable to perform resection of the root apex - if a granuloma, fibroma, cyst, or other complications are detected around the root apex.

What material should be used for temporary filling?

There are special requirements for the material used for filling:

• Creating complete tightness, which is achieved by penetrating even the smallest cracks. This helps create a kind of barrier that prevents the development of bacteria. If microorganisms develop a small cavity into which they can penetrate, the inflammatory process will re-develop.
• The materials should be clearly visible on x-ray. Thanks to this, the doctor is convinced that high-quality work has been done.
• High aesthetics. The material should not be visible through tooth enamel.
• Saliva, hard or soft tissues of the oral cavity should not provoke an allergic reaction by contacting the filling mass.
• Materials for temporary filling of root canals should be easily removed from the roots. After the substance hardens, a slight shrinkage effect may appear, but no cavities are formed.

Treatment of tooth canals under a microscope

One of the most advanced methods in endodontics is root canal treatment under a dental microscope. Powerful optics increases the view many times over; given the channel diameter is no more than 1 mm, it is very difficult to process it efficiently without magnification.

Advantages of dental treatment under a microscope:

The doctor clearly sees the structural features of the canal mouths, every deviation from the direction, which is important when the root canal has a non-standard shape. The microscope makes it possible to preserve healthy tissue by removing only diseased tissue. Thanks to the targeted examination of tissue under the Labomed Magna dental microscope, which is available in the clinic, our highly qualified specialists will ensure the best outcome of the intervention, eliminating the likelihood of problems and complications.

Using a dental microscope allows the dentist to successfully solve any complex clinical problem. At the Implantmaster dental clinic, tooth canal treatment under a microscope is performed at affordable prices, which can be found on the website.

Read more about dental treatment under a microscope »

How does filling occur?

Before temporary filling of the canals begins, the patient is sent for an X-ray examination. Using the image, the extent and depth of the lesion is determined. Then a technique is selected and the procedure begins. It consists of the following steps:

1. Administration of anesthesia. Local anesthesia is used. Many patients have a fear of the sound of the drill, even if there is no pain. These patients are given intravenous sedation.

2. Clean the tissues affected by caries (enamel, dentin).

3. The dental nerve is removed.

4. Probe the root passage. Its depth is determined.

5. The width of the passage is expanded and drilled.

6. Wash with an antiseptic solution and dry.

7. If necessary, a pin is inserted.

8. Material is placed into the cavity, taking into account the developed technique.

9. Carrying out a control x-ray examination.

Possible complications after root canal treatment

Sometimes treatment does not go smoothly and complications arise:

• Perforation is the appearance of cracks in the walls of the canals. The solution is treatment with medications and filling.
• Cheek swelling. The reason for the swelling of the cheek after root canal treatment is the penetration of the anesthetic into the periodontal tissues and mucous membranes, which easily absorb liquid.
• Tool failure. The files that process the canal walls are thin jagged needles. If it breaks during the necessary actions, the fragments are removed by specialized devices. Innovative tools are made from nickel and titanium alloys; they are more wear-resistant and durable.
• Adverse reactions to medications. The spectrum and their effects on topical anesthetics are minimized. Before administering drugs, the doctor must collect data on drug intolerance - so the possibility of allergies is close to zero. Moderate and minor adverse reactions are most often short-lived and can be overcome by replacing the drug.
• Other complications. Accidental swallowing of pieces of filling material, dust from teeth, and small instruments is now essentially non-existent due to the use of a rubber dam - a latex scarf that isolates one to several teeth from the oral cavity.

What does pain after filling mean?

The presence of discomfort for three to five days after the procedure is normal. The reason for their appearance is irritated gum tissue and pulp. The patient may complain of a feeling of fullness inside the treated tooth. This is also normal.

To avoid negative consequences, you should contact only an experienced and qualified specialist. Otherwise, the following consequences may arise due to mistakes made:

• A through hole is formed in the root canal.
• Secondary inflammation develops under the filling material.
• Flux and fistula develop.
• A cyst or granuloma forms.
• Allergic reaction to the material.

By choosing a clinic that has a good reputation, you can not be afraid of the above problems.

Dentists' mistakes when filling canals -

• Incorrect measurement of root canal length –

  
  Root canals in a tooth must be filled strictly to the apex of the tooth root.
  To do this, it is necessary to correctly determine the length of each root canal. Errors at this stage lead to the fact that the canals are either filled not to the apex of the root, or the filling material is carried beyond the apex of the root, directly into the bone. In the unfilled part of the canal, an infection develops, which leads to the formation of inflammatory foci at the apexes of the roots of the teeth, for example, apical granulomas or radicular cysts, which is accompanied by periodic suppuration and the appearance of pain when biting on this tooth. Refilling the canals can also lead to long-term pain, neuralgia, numbness of the lip and chin.

• Poor quality mechanical processing of the canals - such processing is necessary to widen the canals and give them a slightly conical shape. Only under this condition can they be sealed later. Numerous mistakes by the dentist at this stage (insufficient expansion of canals, formation of steps, root perforations) lead to subsequent poor-quality fillings and, again, to the development of inflammatory complications requiring new expensive retreatment.

Types of fillings

There are 2 types - temporary and permanent root canal filling.

The first method uses a non-hardening paste, which is distinguished by the presence of medicinal properties. Getting a good result occurs due to calcium hydroxide. The use of temporary filling is indicated for advanced pulpitis, when the inflammatory process has spread quite deeply. A special material is placed into the cavity and covered with a filling. Installation of a permanent filling may take several days or even months.

The second method (permanent filling) is carried out for more than a dozen years. The procedure is allowed immediately during the first visit to the doctor, if there is no inflammatory process, or after treatment with temporary material has ended.

Stages of dental root canal treatment

Tooth canal treatment is performed using different methods. Initially, a diagnosis is made and a treatment plan is drawn up. Root canal treatment is a very painful process, so anesthesia is required, agreed upon with the patient. An anesthetic injection is given into the gum of the disturbing tooth. After isolating the working field with a rubber dam, the doctor begins the main stages of root canal treatment:

1 . Extraction of affected dentin . An approach to the root canals is provided by opening the dental cavity and sawing off the overhanging edges to gain access to the mouths of the canals. In case of pulpitis of a tooth with several roots, persistent pain may be experienced, then the first visit to the doctor ends with the opening of the tooth cavity and the introduction of devitalizing paste. A temporary filling is placed on top.

2 . Removal of coronal pulp . The second visit is already painless, because... the devitalizing paste will work. With periodontitis, at the time the dental cavity opens, the canals may already be opened or the destroyed pulp may need to be removed. This stage is called devital amputation. In case of pulpitis, under the influence of an anesthetic, partial extraction of the “living” pulp is carried out - the stage of vital amputation.

3 . Channel processing . The canals are cleaned and expanded to remove microorganisms and prevent them from entering the dentin. Wash the putrid masses using solutions with hydrochloride for disinfection. Next, the canals are dried and filled with a medicinal preparation.

4 . Filling the canals is the last step of effective treatment. When treating root canals of teeth, the price includes each material separately. Therefore, the cost of root canal treatment depends on the chosen filling component.

Types of pastes

Paste containing an antibiotic and a corticosteroid

In most cases, such a paste contains 2-3 broad-spectrum antibacterial drugs and a corticosteroid. Basically, it is dexamethasone. The paste contains it in a certain amount, therefore, while reducing inflammation and allergic reactions, there is no disruption of the periodontal protective reactions. The third component is a radiopaque filler. Thanks to him, it is possible to objectively assess how well the channels have been filled. This paste has a strong, but not long-lasting effect. The duration of their presence in the dental canals varies from three to seven days.

Paste containing metronidazole

This component helps to effectively suppress pathogenic microflora in the root canals, stop kagabolic tissue destruction, and block the inflammation process. The patient will not have an allergic reaction to such a paste, and there is also no need to be afraid of addiction.

A paste with this component is used in case of excessive infection of the canals. In addition, such a remedy can cure the acute stage of periodontitis. As a result, re-infection can be easily prevented. Also, the disease progresses much easier.

Paste based on a long-lasting antiseptic mixture

This type of paste consists of antiseptic components that have a strong effect - camphor, thymol, cresol, menthol, etc. This is a radiopaque paste, it does not harden, and gradually dissolves in the root canal. Indications for the use of such a paste are the presence of pulpitis, periodontitis, and problems with baby teeth.

Calcium hydroxide paste

A highly alkaline reaction occurs; when the canal is filled with this substance, various bacteria are destroyed and necrotic tissue is destroyed. In addition, stimulation of ostogenesis, dentinogenesis and cementogenesis begins.

The use of a non-hardening paste, which includes calcium hydroxide, is necessary for severe periodontitis, cystogranuloma. This mass is placed in the channel; a special channel filler is used for this purpose.

After six weeks, the paste is replaced. A new portion is placed into the root canals. After this, the paste is changed every eight weeks until the desired result is achieved. If the pain and inflammation have disappeared, and exudation has stopped, the doctor cleans the canals and fills them with permanent filling material.

How painful is root canal treatment?

Unpleasant sensations in the tooth occur under the influence of microorganisms on the vessels and nerve at the root. Cleaning the canals and removing the inflamed pulp eliminates pain. With the use of modern anesthetics, endodontic treatment proceeds comfortably. Treatment of 1 tooth canal lasts about forty minutes (depending on the complexity of the root anatomy); a three-canal tooth may require about two hours. In our clinic, doctors carry out all procedures for root canal treatment at a reasonable price using a rubber dam to limit the working field and ensure comfort for the patient.

Prices for root canal treatment

Treatment of caries by filling tooth surfaces

• Anesthesia
• Cavity preparation (preparation, medicinal treatment, application of a gasket)
• Filling with light-curing composite
• Grinding and polishing the filling
• X-ray images

Price : from 3,000 ₽ to 8,050 ₽, depends on the number of tooth surfaces affected.

The cost depends on many factors: the degree of destruction of hard tissues, the number of roots and canals in them, and treatment methods. The prices for the service provided are relatively high due to the structural features of the roots of the teeth - they are narrow, thin, branched, requiring the doctor to have high precision and professionalism. The cost of manipulations, which include root canal treatment, is announced to the patient at the first visit; for the most part, it is free. To clarify the diagnosis, an X-ray is taken, and at the end of treatment a final image is taken.

The cost of treatment for a single-canal tooth starts from 15,000 rubles. One visit involves using a microscope for 30 minutes and not using medicinal paste. If the tooth has previously been treated, then a filling is added, the cost of which varies from 1,500 rubles to 2,500 rubles for 1 channel. Therefore, endotherapy of a tooth starts from 16,500 rubles for a single-canal tooth in one visit. The price for dental treatment with 2 or more canals increases significantly. In such situations, the doctor pays separate attention to each canal, spending more of his time and filling composite.