Feature of two channels
The canals of the premolars are narrow and often curved, and the second canal is hidden under a canopy of dentin. Both need to be found and treated equally carefully: a canal left untreated will retain the infection, and the lesion at the root will not close, even if the second canal is perfectly sealed.
What is periodontitis
Periodontitis is an inflammation of the tissues that surround the tip of the tooth root. It develops when the infection from the canal extends beyond its boundaries: most often it is advanced pulpitis or a consequence of poorly treated canals.
In the picture, periodontitis is visible as a dark spot at the apex of the root - the focus of bone destruction. It may not hurt for years and only worsens with a cold or stress, but all this time the lesion persists and grows slowly.
Why does treatment take place in several stages?
Unlike pulpitis, with periodontitis it is not enough to clean out the canal - you need to give the body time to close the lesion in the bone. To do this, the canals are temporarily filled with a paste based on calcium hydroxide: it disinfects the canal and stimulates the restoration of bone tissue.
After 2–4 weeks, the paste is changed or, if the inflammation has subsided, the canals are filled with permanent material. Therefore, the treatment of periodontitis is divided into separate stages - treatment, temporary and permanent filling.
Stages of treatment
- mechanical and medicinal treatment of canals - opening, removal of infected tissue, rinsing with antiseptics
- temporary filling of channels with calcium hydroxide - disinfection and stimulation of bone restoration
- permanent filling of root canals - hermetically sealed with gutta-percha with a control image
Forecast
With proper treatment, the lesion at the root apex shrinks within 3 months and in most cases completely closes within 6–12 months. If this does not happen, a surgical option is discussed - resection of the root apex.