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Home-DE Dr.med.dent Deniza Ianev

M.Sc. in Dental Prosthetics


 At the center of your tooth is pulp. Pulp is a collection of blood vessels that helps to build the surrounding tooth. Infection of the pulp can be caused by trauma to the tooth, deep decay, cracks and chips, or repeated dental procedures. Symptoms of the infection can be identified as visible injury or swelling of the tooth, sensitivity to temperature or pain in the tooth and gums.


This injured pulp is removed and the root canal system is thoroughly cleaned and sealed. This therapy usually involves local anesthesia and may be completed in one or more visits depending on the treatment required. We use local anesthesia to eliminate discomfort. You will be able to drive home after your treatment, and you probably will be comfortable returning to your normal routine.


High-Tech for the root canal.


The root canal system is extremely delicate and often branched. The diameter of a channel measures only fractions of a millimeter (!). The conventional imaging using two-dimensional X-ray images is often insufficient for the display these three-dimensional canal structures. In terms to offer you an optimal treatment result we therefore work with an electronic length measurement.


Root Canal Treatment Procedures:


 (1)  Apicoectomy - An apicoectomy is a surgery that involves the root tip, or the “apex” of the



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 tooth root.  The term “ectomy” means to excise, or cut. During this procedure the area around the root tip is also cleaned to remove any abnormal tissue or cystic formations.


Typically, the treatment is required when an individual has a toothache in a tooth that has already had a root canal procedure. This procedure will remove infection from the tooth root and bone around the tooth in order to prolong the useful life of the tooth.


On the day of the procedure, the patient is made comfortable in a treatment room, and the appropriate anesthesia is provided. The patient will be made as comfortable as possible.  The gum is lifted from an area near the root area of the tooth.  Your doctor accesses the root tip by removing the thin bone covering the end of the root.  A small part of the root tip is then removed, and the remaining root is checked to make sure that it is sealed. All canals are checked to be sure they are properly sealed, and a root-end filling is placed to prevent reinfection of the root.  The gum is sutured closed, and the bone naturally heals around the root over a period of months.


After surgery, the patient will be observed in the office and discharged when appropriate. Follow up will be arranged for the following week. Typically, recovery is rapid with perhaps 1-3 days of minor swelling and discomfort. Patients can usually resume usual activities within 24 hours.


(2)  Intentional Replanation -This is defined as the purposeful extraction of a tooth in order to perform an extra-oral (out of the mouth) root canal treatment. This treatment can involve the sealing of the root ends and/or repairing defects in the crown or root(s).


The procedure is carried out in the dental office in association with an oral surgeon who extracts the tooth. The repair and resealing is then done by the Endodontist. The tooth is out of the mouth for 5-15 minutes. Once the extra oral procedure has been completed, the tooth is re-inserted into the socket. If there is a pre-existing abscess, the oral surgeon will remove the infected tissue before the replantation. The tooth rarely requires any splinting to maintain stability.

Following the completion of the procedure, it is necessary to maintain pressure on the tooth for the rest of the day to prevent the tooth from moving in the socket. Any prescribed medicine should be taken as indicated. A specific mouth rinse (Peridex) is often used for 1-2 weeks.


The post-operative pain is usually moderate for most cases, however, in rare instances it can be severe. This is usually well controlled by prescription pain medication. This period of discomfort is generally 2-3 days, but on rare occasions can continue in a milder form for 1-2 weeks.


The tooth will be examined over the next few years to check the success of the procedure. The first three years are critical and if there is no sign of root resorption during this time, the tooth has an excellent long-term prognosis.