Endodontics in Santiago
Root canal treatments with magnification, rotary instrumentation and thermoplastic obturation. Led by Dr. Valentina Gormaz, Master's in Endodontics from the University of Valencia.
Endodontics treats the root canal system when the dental pulp becomes inflamed or necrotic. When a tooth has deep caries, coronal fracture with pulp involvement, or trauma, endodontic treatment is what allows preserving the natural tooth instead of extracting it. Preserving the patient's own tooth is always the first clinical option.
The protocol is performed with absolute isolation of the operating field (rubber dam), profound local anesthesia, and conscious sedation when indicated. We work under magnification with loupes or operating microscope, which allows visualizing accessory canal openings that go undetected without magnification. That difference is what separates a clinically complete endodontic treatment from one with un-instrumented canals that progress to re-treatment years later.
Instrumentation is rotary with state-of-the-art nickel-titanium files, which reduces operative time and intracanal fracture risk. Irrigation is active with sodium hypochlorite and EDTA, which dissolves pulp remnants and bacterial biofilm. Obturation is thermoplastic, sealing the canal system in three dimensions, including lateral and accessory canals that traditional lateral condensation with gutta-percha cones doesn't reach.
Prior diagnosis includes clinical examination, pulp vitality testing, and periapical radiography. In cases with complex root anatomy (upper molars with MB2 canals, teeth with calcifications, suspected vertical fractures), we indicate cone-beam tomography (CBCT) before starting. Pre-planning with CBCT changes clinical management in approximately one of every five complex cases, prevents perforations and allows locating canals that 2D radiography doesn't show.
Pain is the most common concern. The clinical reality is that a well-executed endodontic treatment is painless during the session thanks to local anesthesia. Post-treatment residual inflammation is managed with anti-inflammatories and resolves in 24 to 72 hours in most cases. Severe post-endodontic pain is uncommon and always has an identifiable cause that requires clinical evaluation.
Most endodontic treatments are completed in a single session when there is no active infection with drainage. Cases with acute apical periodontitis, abscesses with suppuration, or particularly complex root anatomies may require two sessions, with intracanal medication between visits. The decision is clinical, based on the state of the tooth at the start of treatment.
After endodontic treatment, the tooth requires definitive restoration: a crown or onlay depending on the case. Endodontically treated teeth are more fragile because they lose internal hydration and the coronal access weakens the structure. Restoring with a crown or onlay protects the tooth against vertical fracture, which is the most frequent long-term complication of endodontically treated teeth that aren't restored prosthetically. We coordinate the restoration with prosthodontics in the same clinical plan.
When a previous endodontic treatment has failed (persistent symptoms, unresolving periapical lesion, presence of fistula), re-treatment is indicated before considering extraction. Re-treatment involves removing the previous obturation, re-instrumenting the canals, identifying the cause of the original failure (untreated canal, perforation, fracture), and re-obturating. It is more technically demanding, where magnification and CBCT make the difference.
Benefits
- ✓Prior diagnosis with pulp vitality testing and CBCT when indicated
- ✓Magnification with loupes or operating microscope on every treatment
- ✓Absolute isolation with rubber dam without exceptions
- ✓Rotary instrumentation with nickel-titanium files
- ✓Thermoplastic obturation sealing canals in three dimensions
- ✓Led by Dr. Valentina Gormaz, Master's in Endodontics from the University of Valencia
- ✓Coordination with prosthodontics for definitive restoration in the same clinical plan
- ✓Endodontic re-treatments in cases with prior failure
Our Approach
The protocol starts with complete diagnosis: clinical examination, pulp vitality testing, periapical radiography, and CBCT when anatomy or symptoms justify it. The session is performed with absolute isolation of the operating field via rubber dam, profound local anesthesia, and work under magnification with loupes or operating microscope. Instrumentation is rotary with nickel-titanium files, irrigation is active with sodium hypochlorite and EDTA, and obturation is thermoplastic to seal the canal system in three dimensions. Definitive restoration (crown or onlay) is coordinated with prosthodontics in the same clinical plan, because endodontic treatment without subsequent prosthetic restoration has a high risk of vertical fracture at medium term.
Frequently Asked Questions
When is endodontic treatment necessary?
When the dental pulp is irreversibly inflamed or necrotic. The most frequent causes are deep caries, coronal fracture with pulp involvement, dental trauma, or previous deep restorations that have compromised the pulp. Typical symptoms are spontaneous pain, pain to cold or heat that persists after the stimulus, pain on chewing, or presence of an abscess. The indication is confirmed with pulp vitality tests and radiography.
Is a root canal treatment painful?
Not during the session. Profound local anesthesia eliminates pain during treatment. Post-treatment residual inflammation is managed with anti-inflammatories and resolves in 24 to 72 hours in most cases. Patients with active infection may require antibiotic prior to endodontic treatment to reduce local inflammation.
How many sessions does a root canal take?
Most are completed in a single session when there is no active infection with drainage. Cases with acute apical periodontitis, abscesses with suppuration, or complex root anatomies may require two sessions with intracanal medication between visits. The decision is clinical.
What happens if I don't get the indicated root canal?
Pulp infection progresses. If the pulp is necrotic and untreated, bacteria spread to the periapical bone, forming chronic periapical lesions or acute abscesses. Dental extraction ends up being the only option when the tooth becomes structurally compromised or when the infection becomes systemic. Timely endodontic treatment preserves the tooth; delaying it usually costs the piece.
Do I need a crown after endodontic treatment?
In most cases yes. Endodontically treated teeth are more fragile because they lose internal hydration and the coronal access weakens the structure. A crown or onlay protects against vertical fracture, which is the most frequent long-term complication. The exception is incisors with conservative access and little structural loss, where a direct adhesive restoration may be sufficient.
Does a root canal last forever?
It has success rates exceeding 90% at 10 years when performed with proper protocol (magnification, isolation, three-dimensional obturation) and prosthetically restored. Failures are generally associated with canals undetected in the original treatment, coronal leakage due to deficient restoration, or vertical root fractures. When there is failure, re-treatment is the first option before considering extraction.
What is endodontic re-treatment?
It's the treatment of a tooth that has already been endodontically treated and presents failure (persistent symptoms, unresolving periapical lesion, fistula). It involves removing the previous obturation, identifying and treating the cause of the original failure (untreated canal, perforation, sub-obturation, micro-fracture), and re-obturating. It is technically more demanding than a primary endodontic treatment; magnification and CBCT are determining factors.
Why does AS Odontología Digital indicate CBCT for endodontics?
Because 2D periapical radiography doesn't show accessory canals, internal calcifications, vertical micro-fractures, or true three-dimensional root anatomy. In upper molars, for example, the MB2 canal (second mesiobuccal canal) is present in approximately 60-80% of cases and is identified with CBCT before treatment, not during. Pre-planning changes clinical management in approximately one of every five complex cases.