Devitalization, in medical terms called root canal therapy, is the treatment for the treatment of deep caries and consists in the removal of the infected portion of the tooth pulp and the subsequent restoration of the treated part. In what cases can a failure of the devitalization occur?
What happens when a failure of devitalization occurs
The symptomatology of a failure of devitalization can also occur after several months of treatment. The symptoms are related to the persistence of bacteria in the root canal even after therapy, a condition that determines the failure of the devitalization.
Symptoms
- swollen gums near the treated area;
- devitalized tooth pain;
- continuous inflammation.
The infection can remain symptom-free for years after treatment, but this can be evidenced by simply performing a diagnostic imaging test.
Because the failure of devitalization occurs
The main causes are the following:
Resistant bacteria in the dentinal tubules
In the presence of caries, the bacteria erode the enamel until it reaches the dentin and the pulp of the tooth. In particular, dentin is composed of multiple dentinal tubules in which bacteria can nest. Root canal therapy is not always able to eliminate all the bacteria present, some are particularly resistant and hidden inside the tubules continue to proliferate even after devitalization.
Presence of branching of root canals
The root canal files used by the dentist to clean up the root canal are not always able to reach all the branches present. Some ramifications are particularly articulated and some bacteria can nest in points unreachable by the files.
Choking of root canals
Tartar can clog the root canals and prevent the passage of dental instruments. Some bacteria therefore remain confined to the bottom of the tooth, near the root, with the probability of giving rise, in addition to the failure of devitalization, also to an apical granuloma.
Microcracks
The devitalized tooth may present micro-lesions on the filling. In this case, bacteria can infiltrate and give rise to a new infection.
In this case, bacteria can infiltrate and give rise to a new infection.
The failure of root canal treatment leads to two possible consequences:
- a new devitalization;
- tooth fall.
A latent infection following the failure of devitalization can affect the periodontal ligament, when this condition occurs the tooth loses its stability until it falls.
However, the scientific literature records a 95% success rate in root canal treatment, so failure represents the minimum percentage of 5%. In dentistry the rule of prevention always remains valid, namely to prevent tooth decay or to avoid neglecting it for a long time is the best solution to avoid the devitalization of the tooth and consequently its eventual failure.
Turning to dentists specialized in endodontics, the likelihood of incurring an implant failure decreases significantly.
