Dr Karun Gupta
Endodontic therapy or root canal therapy is a sequence of treatment for the infected pulp of a tooth which results in the elimination of infection and the protection of the decontaminated tooth from future microbialinvasion. Root canals and their associated pulp chamber are the physical hollows within a tooth that are naturally inhabited by nerve tissue, blood vessels and other cellular entities which together constitute the dental pulp.
Endodontic therapy involves the removal of these structures, the subsequent shaping, cleaning, and decontamination of the hollows with small files and irrigating solutions, and the obturation (filling) of the decontaminated canals with an inert filling such as gutta-percha and typically a eugenol-based cement.
Root canal therapy can be completed in multiple visits(usually3-5 visits) or it can be completed in single visit(30-45 mins). There are several misconceptions about single sitting root canal therapy which i have tried to clarify in this article.
Misconceptions about painless single sitting RCT
It is quite painful after sealing.
Previously, it was considered to be painful after obturation especially in non-vital teeth.
But now, with revolutionary changes in concepts, it is considered as a routine & painless procedure even in non-vital teeth cases. Rather statistics reveals that single visit root canal treatment causes pain less frequently than multiple visit root canal treatment.
Canal cleaning can’t be completed in one sitting as dentist can’t insert intra canal medicament.
Canal cleaning by intra canal medicament is also now a day considered as least useful. Instead, proper biomechanical preparation of root canal(upto proper size), profuse irrigation by proper irrigants, immediate sealing of main root canal, lateral accessory canals & dentinal tubules by 3 dimensional obturation gives prompt healing. Also bacteria in completely & tightly sealed dentinal tubules get killed due to deprivation of nutrition.
Single sitting rct is very time consuming.
Critics claim that single sitting rct requires a lot of time. This claim also failed due to advancement of niti rotary files i.e. rotary endodontics. So an average time required for single sitting rct is 45mins to 60mins (for access opening to obturation).
Periapical lesions doesn’t get healed by single sitting root canal treatment.
Root canal treatment confines to tooth structure only. Periapical lesion is located outside the tooth structure. Lesion is surrounded by a connective tissue with good blood supply. It gets healed by our body’s own healing mechanism & drugs reaching till lesion through blood supply. Always remember aim of rct is just to remove irritant which is main etiology by mechanical means. So, neither single visit nor multiple visits rct causes healing but it helps healing. Healing depends only on body’s inflammatory response.
Recently I have done a case of Mr. MaqboolGorsi ,50 yr old male, in which I have done 14 upper teeth root canal treatment in a single day and 12 lower teeth root canal tretament on the next day,followed by full mouth rehabilitation procedure.The patient is happily enjoying his full set of fixed teeth after single visit root canal treatment.
(The author is Oro-Dental Surgeon, Implantologist)