End­odon­ti­cs

Pre­ser­ving tee­th for a life­time is not always straight­for­ward – espe­ci­al­ly when they are infla­med. Howe­ver, in most cases, your natu­ral tee­th are supe­ri­or to even the best arti­fi­ci­al repla­ce­ments. A root canal tre­at­ment can achie­ve this with a high degree of suc­cess. On this page, we aim to explain the most important aspects of root canal tre­at­ment to you.

Our Root Canal Spe­cia­lists

DR. MAR­CO
GEOR­GI, M.Sc.

DR. HEN­NING
BAHNEMANN, M.Sc.

CHRIS­TOF
RIF­FEL, M.Sc

Dr. Geor­gi, Dr. Bahnemann, and Mr. Rif­fel are our spe­cia­lists in end­odon­ti­cs.

As a spe­cia­list in micro­sco­pic end­odon­ti­cs, revi­si­on tre­at­ment, and micro­sur­gery, Dr. Geor­gi is a sought-after lec­tu­rer at many con­ti­nuing edu­ca­ti­on insti­tu­tes. For more than 10 years, he has also taught inter­na­tio­nal­ly and holds the sci­en­ti­fic direc­tor­ship for end­odon­tic con­ti­nuing edu­ca­ti­on at the Hes­si­an Sta­te Medi­cal Asso­cia­ti­on. He is the foun­ding pre­si­dent of the Asso­cia­ti­on of Ger­man Cer­ti­fied End­odon­tists (VDZE)

Dr. Bahnemann is also an expe­ri­en­ced spe­cia­list in end­odon­ti­cs and micro­sco­pic den­ti­stry. He is also an expert in den­tal hyp­no­sis. Dr. Bahnemann is Vice Pre­si­dent of the VDZE and ser­ves as a spea­k­er in the field of end­odon­ti­cs.

Chris­tof Rif­fel spe­cia­li­zes in pedia­tric end­odon­ti­cs, trau­ma­to­lo­gy, and den­tal hyp­no­sis. He is a long-stan­ding acti­ve mem­ber of the Asso­cia­ti­on of Ger­man Cer­ti­fied End­odon­tists (VDZE).

Why Does My Tooth Beco­me Dise­a­sed?

In most cases, a tooth beco­mes dise­a­sed due to caries bac­te­ria, but acci­dents, den­tal, or orth­odon­tic tre­at­ments can also be the cau­se. Inflamm­a­ti­on or infec­tion insi­de the tooth is the result of such sti­mu­li.

Insi­de a tooth, a canal sys­tem bran­ches out, con­tai­ning living tis­sue (pulp) with ner­ves and blood ves­sels. Unfort­u­na­te­ly, the defen­si­ve capa­ci­ty of this tis­sue is very limi­t­ed, so the body some­ti­mes can­not ade­qua­te­ly ward off the sti­mu­li and heal the dise­a­se.

Pre­vious­ly, the­re was no saving such tee­th. Sin­ce a tooth’s canal sys­tem is often very deli­ca­te and has many cur­vat­ures, the­re was no tre­at­ment opti­on, and the tooth had to be extra­c­ted. Today, things are com­ple­te­ly dif­fe­rent…

WHY A ROOT CANAL TRE­AT­MENT?

If your den­tist recom­mends tre­at­ment with an end­odon­tist, the­re is a sus­pi­ci­on or cer­tain­ty that some­thing is wrong with the insi­de of a tooth.

Trea­ting spe­cial cases requi­res spe­cia­li­zed trai­ning and exten­si­ve expe­ri­ence in this field – as well as par­ti­cu­lar tech­no­lo­gy to visua­li­ze and tre­at the hair-fine canals insi­de the tooth.

In the past, tee­th with dise­a­sed roots were often extra­c­ted. Today, advan­ced tech­no­lo­gies and medi­cal deve­lo­p­ments make it pos­si­ble to save tee­th that were once thought almost lost.

The suc­cess rate is reassu­rin­gly high: most tee­th can be pre­ser­ved with a well-foun­ded end­odon­tic tre­at­ment and a good pro­gno­sis!

What Can the Den­tist Do to Pre­ser­ve My Tooth?

To pre­ser­ve an infla­med or non-vital tooth, its root must be trea­ted. The bac­te­ria in the tooth must be remo­ved, and the tooth must be sea­led so effec­tively that no new germs can enter.

Sin­ce the tooth’s root sys­tem, simi­lar to a tree, has many small rami­fi­ca­ti­ons (some only a few hundredths of a mil­li­me­ter in size!), the­se can only be made visi­ble under a micro­scope. This tech­ni­que, along with appro­pria­te­ly fle­xi­ble and micro-fine instru­ments, allows for opti­mal pre­pa­ra­ti­on to remo­ve bac­te­ria and dise­a­sed tis­sue – and thus a grea­ter tre­at­ment suc­cess.

In pre­pa­ra­ti­on for fil­ling the root canal sys­tem, the root canals are pre­pared with high­ly ela­s­tic micro-files. For fil­ling the canal sys­tem, gut­ta-per­cha, a mate­ri­al rela­ted to natu­ral rub­ber, is hea­ted and intro­du­ced into the now opti­mal­ly pre­pared sys­tem in com­bi­na­ti­on with an adhe­si­ve cement.

Only if the root sys­tem is tho­rough­ly clea­ned of bac­te­ria can the infec­tion be eli­mi­na­ted and the bone heal again!

What is the Likeli­hood of Pre­ser­ving My Tooth?

Natu­ral­ly, it depends on indi­vi­du­al cir­cum­s­tances, such as the stage of inflamm­a­ti­on and oral hygie­ne. Howe­ver, the ana­to­my of the tooth and poten­ti­al­ly addi­tio­nal fac­tors, such as loss of the peri­odon­ti­um due to cyst for­ma­ti­on, also play a signi­fi­cant role. Long-term stu­dies in the USA and Scan­di­na­via show­ed a suc­cess rate of over 80% for pro­fes­sio­nal end­odon­tic tre­at­ment using the metho­do­lo­gy men­tio­ned abo­ve.

What Does the Tre­at­ment Cost?
The cost of tre­at­ment depends on the time requi­red. This is deter­mi­ned befo­re tre­at­ment based on indi­vi­du­al cir­cum­s­tances such as the stage of inflamm­a­ti­on and the ana­to­my of the tooth.
Howe­ver, such a spe­cia­li­zed, indi­vi­dua­li­zed, and neces­s­a­ri­ly deman­ding tre­at­ment is not cover­ed by health insu­rance. They only cover a small por­ti­on of the cos­ts. The remai­ning por­ti­on must be bor­ne pri­va­te­ly by the pati­ents. The­r­e­fo­re, a detail­ed and bin­ding cost esti­ma­te will be pre­pared for your indi­vi­du­al case befo­re the start of tre­at­ment.
What Alter­na­ti­ves are the­re?
Often, the only alter­na­ti­ve is to extra­ct the tooth and fill the resul­ting gap with an implant. The cos­ts for res­to­ring your natu­ral smi­le should not be unde­re­sti­ma­ted eit­her. They are often signi­fi­cant­ly hig­her than tho­se of a root canal tre­at­ment.
Com­mon Mis­con­cep­ti­ons about Root Canal Tre­at­ments

Mis­con­cep­ti­on: Root canal tre­at­ments are pain­ful.

Truth: Root canal tre­at­ments do not cau­se pain; ins­tead, they eli­mi­na­te it.

Sto­ries about pain­ful root canal tre­at­ments have not­hing to do with modern end­odon­ti­cs. Today’s anes­the­tics (pain-eli­mi­na­ting injec­ta­bles) and tar­ge­ted end­odon­tic tech­ni­ques make a root canal tre­at­ment no less com­for­ta­ble than pla­cing a fil­ling.

Most pati­ents visit their den­tist or end­odon­tist when they have per­sis­tent tooth­ache. Such pain often ori­gi­na­tes from dise­a­sed pulp (ner­ve) tis­sue insi­de the tooth. During root canal tre­at­ment, the dise­a­sed tis­sue is remo­ved, ther­eby eli­mi­na­ting the cau­se of the pain.

A sur­vey show­ed that pati­ents who had expe­ri­en­ced a root canal tre­at­ment descri­bed it as “pain­less” six times more often than pati­ents who had not yet recei­ved a root canal tre­at­ment.

 

Mis­con­cep­ti­on: Root canal tre­at­ments cau­se dise­a­ses.

Truth: Root canal tre­at­ments are a safe and suc­cessful tre­at­ment.

In the past, a small group of medi­cal pro­fes­sio­nals clai­med that the­re was a con­nec­tion bet­ween root-trea­ted tee­th and the occur­rence of cer­tain dise­a­ses. This opi­ni­on is based on the long-out­da­ted stu­dy by Dr. Wes­t­on Pri­ce from the peri­od of 1910–1930!

Many sci­en­ti­fic stu­dies published in this field for over 70 years show that the­re is no con­nec­tion bet­ween root canal fil­lings and any type of dise­a­se. The most recent rese­arch on this topic cle­ar­ly demons­tra­tes that a pro­per­ly root-trea­ted tooth poses no health risk whatsoe­ver.

 

Mis­con­cep­ti­on: A good alter­na­ti­ve to root canal tre­at­ment is tooth extra­c­tion.

Truth: Pre­ser­ving your natu­ral tooth is cer­tain­ly the best choice.

Not­hing can com­ple­te­ly replace your natu­ral tooth. Arti­fi­ci­al tee­th some­ti­mes force you to chan­ge your eating habits. Pre­ser­ving your own tee­th means main­tai­ning the joy of eating and its diver­se plea­su­res. Root canal tre­at­ment is the most bio­com­pa­ti­ble way to tre­at the dise­a­se of the tis­sue insi­de your tooth (pulp).

Good root canal tre­at­ments have a very high suc­cess rate. Many tee­th last a life­time after­ward. Repla­cing lost tee­th with bridges, den­tures, or implants usual­ly requi­res more time and finan­cial effort. Fur­ther­mo­re, tre­at­ment of adja­cent tee­th and sur­roun­ding tis­sues is often neces­sa­ry.

Root Canal Tre­at­ment

Not­hing is as beau­tiful and func­tion­al as your natu­ral tee­th. Modern end­odon­ti­cs makes it pos­si­ble to per­ma­nent­ly pre­ser­ve even com­pro­mi­sed tee­th. This video demons­tra­tes how a root canal tre­at­ment works.

A Cra­cked Tooth

When a tooth is cra­cked, it is important to pre­vent inflamm­a­ti­on from forming under­neath. Root canal tre­at­ment eli­mi­na­tes pain and pre­vents the pro­blem from wor­sening.

Treatment under the operating microscope

The Ope­ra­ting Micro­scope: Pre­cise Con­trol of the Tre­at­ment Pro­cess

To safe­ly tre­at the fine, bran­ched canals, good visi­bi­li­ty is not only hel­pful but abso­lut­e­ly essen­ti­al in modern end­odon­to­lo­gy. With the naked eye, the fine ent­ran­ces to the canals are often not visi­ble. If one reli­es sole­ly on tac­ti­le sen­sa­ti­on, many canals and niches remain hid­den. Tis­sue rem­nants and bac­te­ria left the­re can lead to a recur­rence of inflamm­a­ti­on even years after tre­at­ment.

A Micro­scope is Essen­ti­al

Only 39% of root canal tre­at­ments per­for­med con­ven­tio­nal­ly (wit­hout an ope­ra­ting micro­scope) in Ger­ma­ny are suc­cessful, and only 12% of tre­at­ments show results that meet the requi­re­ments of the ESE (Euro­pean Socie­ty of End­odon­to­lo­gy).

DIGI­TAL VOLU­ME TOMO­GRA­PHY (DVT)

With Digi­tal Volu­me Tomo­gra­phy (DVT), a new era in dia­gno­stics began in end­odon­to­lo­gy. The high-reso­lu­ti­on 3D images, which depict the tooth in fine lay­ers, are not only dis­tor­ti­on- and super­po­si­ti­on-free but also true to sca­le.

X‑rays are stan­dard in every den­tal prac­ti­ce today and are rela­tively easy to pro­du­ce. Howe­ver, the dia­gno­stic pos­si­bi­li­ties are some­ti­mes insuf­fi­ci­ent, for exam­p­le, due to dis­tor­ti­ons, super­po­si­ti­ons, or ambi­gui­ties cau­sed by expo­sure. In the worst case, this can lead to mis­in­ter­pre­ta­ti­ons. Through DVT dia­gno­stics, the end­odon­tist is able to detect a varie­ty of dise­a­ses of the tee­th and sur­roun­ding struc­tures such as bone or the maxil­la­ry sinus, which other­wi­se could only be visua­li­zed in part with com­plex alter­na­ti­ve cross-sec­tion­al ima­ging pro­ce­du­res (e.g., com­pu­ted tomo­gra­phy, magne­tic reso­nan­ce ima­ging).

The signi­fi­cant­ly lower radia­ti­on expo­sure is ano­ther advan­ta­ge of DVT tech­no­lo­gy com­pared to con­ven­tio­nal CT.

DVT Scans Help, for Exam­p­le, with…
  • suspec­ted inflamm­a­to­ry pro­ces­ses in the jaw­bo­ne cau­sed by tooth roots.
  • when plan­ning end­odon­tic revi­si­ons.
  • bei der Pla­nung mikro­chir­ur­gi­scher Ein­grif­fe an Zahn­wur­zeln in unmit­tel­ba­rer Nach­bar­schaft zu Ner­ven.
  • dia­gno­sis after den­tal acci­dents (cla­ri­fi­ca­ti­on of root and/or jaw frac­tures).
  • inter­nal and exter­nal root resorp­ti­ons.

Our Men­tor: Cliff Rudd­le – Doy­en of End­odon­to­lo­gy

He could be descri­bed as our men­tor: Cliff Rudd­le has con­sis­t­ent­ly inspi­red, sup­port­ed, and encou­ra­ged us. As a stu­dent of the famous father of the “Schil­der phi­lo­so­phy,” Her­bert Schil­der, he fur­ther deve­lo­ped his tech­ni­ques and crea­ted inno­va­ti­ve instru­ments for root canal tre­at­ment, espe­ci­al­ly incre­asing­ly finer and more effec­ti­ve ones. At his lec­tures and work­shops, as well as in pro­fes­sio­nal asso­cia­ti­ons and other con­ti­nuing edu­ca­ti­on events, we repea­ted­ly met and dis­co­ver­ed our shared fasci­na­ti­on for end­odon­to­lo­gy.