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Endodontic Treatment & Surgery in Romania

Smile perfection rests in achieving harmony between the aesthetics and health of your teeth and our specialists always combine state of the art equipment and the art of beauty. Nowadays, the most distinguished researchers and leaders in dentistry confirm and support the indispensable role of the dental microscope that has succeeded in overcoming the limits of the classical treatment in the patient’s benefit on the long term.

The endodontic treatment is essential for the long-term oral health, ensuring at the same time maximum comfort related to the total lack of pain due to “pain FREE” solutions offered by DENT ESTET. The high-technology and the experience of doctors have become vital in providing a beautiful and healthy smile..

Endodontics requirement – the health of teeth from the inside

“The endodontic treatment is a therapy performed on the tooth pulp, aiming at removing the infection as well as preventing further infections”, explains Dr. Erika Vasilescu, an endodontist with a wide experience in endodontic treatments. This treatment involved the complete removal of the root canal content. The interior of the root canal is then cleaned, shaped and decontaminated. The patient will not feel any more pain on this teeth because the nerve tissue has been removed and the infection eliminated.

A patient with an infected pulp displays high sensitivity to high and low temperatures, even when chewing, and this pain can become permanent. If not treated, the infection spreads and the tooth becomes loose and will finally be lost. The infection is usually caused by a deep cavity or a broken tooth. The bacteria enter through a crack, a decay or a lose filling and they eventually destroy the pulp and the bone gets infected. A bone infection will eventually lose it, the ligaments around the tooth get swollen and the tooth becomes loose. “The endodontic treatment removes the infection from the patient’s tooth and prevents extraction”, according to Dr. Vasile Branici, endodontic specialist.

The indispensable instrument – the microscope

In many cases, dentists must distinguish microscopic details impossible to see with the naked eye. Some details, such as early carious lesions, the assessment of the margins of a crown and dental micro-cracks are difficult to analyse without the enhancement of the human visual acuity. Studies have shown that a qualified doctor using a microscope is able to distinguish separate entities even at less than 36 μm (micron).

The microscope has changed the approach for dental treatment, going from the extraction of a tooth to its saving. The microscope offers additional methods for the assessment of decay and of the endodontic treatment, bringing dentistry to the zero-failure level in restorative dentistry. The decision of “extracting or saving” is a constantly developing art.

4 major advantages of using the microscope

Prof. Kim’s motto, “You can only treat what you can see!” has made dentists all over the world enthusiastic about microscopic treatment. In 1998, the American Dental Association (ADA) instituted microscope proficiency as obligatory for all endodontic specialist programs in the United States.

Due to the magnification of up to 25 times and clear coaxial illumination of the working field, it is possible to address unique or specialized treatment situations more efficiently due to the accuracy. By means of the microscope alone these canals can be seen, new canals can be discovered, which are many times neglected, undetected, as they can lead to the failure of endodontic treatments.

Many studies have proven that microscope-assisted work techniques are obviously better than traditional techniques. “Due to the electron microscope, the entire efficiency of the endodontic treatment is optimized, as the root canal is fully visible sometimes while us, as endodontists, can verify whether it is clean. This way, we guarantee treatment success to the patient”, states Dr. Mihnea Constantin, endodontist, reinforcing the efficiency of the microscope for zero-failure level in restorative dentistry.

Double comfort – Ideal ergonomics of medical activity

Time and cost saving

The dentist’s posture during treatment is important for maintaining his health and comfort. In this regard, the microscope is specially designed to provide a correct and efficient work posture of the dentist. At the same time, the patient enjoys the easiness of the therapy and a maximum comfort due to the “Free pain” concept.

Retreatments are mainly due to a low quality of the procedure and involve most of the time higher restoration costs as compared to the initial cost. “Microscope-assisted endodontics involves accuracy and maximum efficiency so that treatment duration is shorter and the long term result is safe, preventing further retreatments and additional costs”, Dr. Vanda Popa explains the indisputable benefits of the microscope.

6  successful dental procedures performed using the microscope

The efficient use of a microscope for dental procedures does not only require training but rather special, clinical skills that are not required in non-microscopic endodontics. In microscopic endodontics, the use of smaller specialized mirrors significantly improves efficiency and capacity. The skills required for handling much smaller mirrors are easy to acquire by dentists but not without effort. The correct ergonomics and a well trained assistant significantly support an endodontist in performing the treatments but a lot of practice and training are required to acquire the skills necessary in the following procedures:

Microfractures and longitudinal fractures are often overlooked clinically and represent a cause of pain that is difficult to diagnose. Thus, visualization under the dental microscope becomes mandatory for further planning a correct and complete treatment.

When examining the radiographic image, there are often signs of unusual root canal shapes. Interruptions in the canal shape are almost always a certain indication of canal system splitting. The shape and number of root canals can vary significantly and the success of the therapy depends on an accurate visualization of the dental field.

These signs occur to a greater or lesser extent in about 50% of all teeth and thus instrumentation and technology become indispensable in performing the treatments. Calcification can even occur on molars of early age patients in 19.7% of the cases.

Modern endodontic procedures require special techniques and materials and this requires the mandatory use of the dental microscope. Soft tissue surgery is also significantly improved due to microscopic procedures, leading to a quicker healing and less injured soft tissues.

As these are accurate procedures, the visualisation of a magnified field plays an essential role in saving the tooth.

The microsurgery concept involves atraumatic procedures, preservation of the bone structure and a minimally invasive technique for optimal results with maximum comfort for the patient. A study run by Professor Kim and Rubinstein shows how the success rate of a traditional apicoectomy was about 60% while the procedure performed using the microscope guarantees a success rate over 97%. Another study show an even higher difference: a 44% success rate for the traditional method and 91% for the microsurgery.