Dental surgery: retrograde root canal filling

There are a large number of techniques that can eliminate the problems of the integrity and safety of teeth. One such technique is filling tooth from the root apex - retrograde filling. In some cases, such an operation is the only way to maintain a beautiful smile.

Features of the method

In practice, dentists often face problems that cannot be solved with conservative methods. This is especially true for root canal filling. Here the work must be done efficiently, otherwise complications are possible. This is especially true of inflammation against the background of the accumulation of pathogenic microorganisms.

The only solution is retrograde filling. It can be used to securely close channel and preserve the integrity of the dentition.

The purpose of the procedure is to prevent the penetration of microbes and their waste products into the canal. In the process, the root apex is resected.

Only then is the direct filling of the root canals performed.

Indications for surgery

The procedure is indicated for teeth that have destructive changes in the peri-apical tissue. The method is also used in the absence of such features.

In the first case, the patient has the following symptoms:

• pain sensations of varying intensity;
• swelling of the gums;
• education fistulous channels;
• inflammatory process.

Many patients turn to specialists after an exacerbation of symptoms. The rest first undergo periostotomy and drug therapy. Antibiotics are used as medicines, which allows to stop the inflammatory process and improve the patient's well-being.

Often people who have previously been provided with low-quality services for installing crowns and filling canals turn to specialists. This leads to complications.

If there are no destructive changes, then the symptoms are mild. In this case, it will be very difficult to detect poorly sealed canals. The only option is to take a panoramic photo to assess the situation.

Retrograde filling is recommended in such cases:

1. Poorly performed canal filling using materials that exclude the possibility of re-treatment of the tooth.
2. The presence of metal objects in the filled tooth, which got there by a gross mistake of the attending physician. This is especially true for novice dentists who are in private practice. A common problem is that a debris from a dental instrument gets into the canal.
3. Root canal destruction.
4. Abnormal structure of the channels. In this case, it is impossible to perform a normal filling.
5. Dental canals have apical deltas and funnel-shaped extensions.
6. The presence of various crowns in combination with the above phenomena.

The need for retrograde filling is determined by the doctor after examining the patient.

What materials are used

Often, retrograde filling is performed using amalgams. This material shrinks slightly and retains its shape well. But despite this, amalgam has a number of disadvantages. In particular, the complexity of use is worth highlighting here.

Before using amalgam, the tooth cavity must be thoroughly dried, which somewhat complicates the procedure. In this case, the material can get into the tissues, which leads to their pigmentation. As a result, the gums darken.

Considering such significant disadvantages of amalgam, modern dentists prefer to use other materials. Among them are:

1. COE. A paste is made from zinc oxide powder and eugenol liquid, which is filled into the cavity of the tooth.
2. Intermediate restoration paste. Compared to amalgam, it allows for better sealing of the tooth cavity. The material can be used in periapical tissues.
3. Super-EBA. The basis of the cementing paste is a powder of zinc oxide and aluminum oxide with a small admixture of natural resins. Compared to amalgam, Super-EBA provides better protection against microorganisms that have not yet manifested themselves.
4. Glass ionomer cements. Light-curing cements are especially popular. They have a high sealing and edge adaptation. These cements are the best alternative to amalgam. They are used as an apical sealant.

The list of filling materials is quite extensive. The specialist selects the best option based on the specific situation.

How is the procedure performed

With retrograde filling, special attention is paid to preparatory work. The result of the procedure will largely depend on this.

Retrograde filling is carried out in the following sequence:

1. Resection the apex of the root. First of all, the flap of the gums is removed from the jaw. After that, the root apex is directly removed.
2. Root shortening. The procedure is carried out until the channels appear.
3. Antiseptic treatment. A cotton swab moistened with a special solution is inserted into the tooth cavity. If necessary, the procedure is carried out several times.
4. Drying the top of the root. After washing, drying is carried out using paper adsorbents or air.
5. The introduction of the filling material is carried out only after all the preparatory work has been completed.
6. Final processing. After the filling is completed, the tooth is treated with an antiseptic. All excess cement is carefully removed.
7. At the final stage, the gum flap is returned to its place.

Postoperative actions

The stitches are removed one week after the operation. On days 2-5, the doctor removes the ichor from the inter-suture space and prescribes laser therapy.

For a month after the operation, there may be soreness and mobility of the teeth.

Final healing occurs in six months. The quality control of the apical root seal is confirmed by an X-ray examination, which must be prescribed by a doctor.

During the postoperative period, the patient is closely monitored. This is due to the fact that complications are possible after surgery:

• suppuration of the wound;
• the occurrence of an inflammatory process;
• crack in the tooth root;
• gum recession.

To rule out the occurrence of such problems, the patient should regularly visit the dentist.