Tooth Nerve Removal (Root Canal Treatment)
— modern endodontic therapy without pain
Why the “nerve” is removed and how this preserves the tooth
Root canal treatment (depulping) is a procedure in which the pulp (soft tissue containing nerves and blood vessels) is removed from the tooth chamber, the canal system is disinfected and sealed. Most commonly it is indicated in cases of deep dental caries, pulpitis and complications of periodontitis; in certain clinical situations, it is required for prosthetic reasons (e.g., to provide reliable support for an inlay or a crown). Unlike old approaches, the goal of modern endodontics is to preserve the natural tooth as much as possible, restoring both function and esthetics.
Pain control and anesthesia: ensuring patient comfort
Modern local anesthetics (such as articaine) provide high-efficiency infiltration and nerve-block anesthesia, allowing treatment to be performed without pain. Systematic reviews indicate that articaine is comparable or even superior to lidocaine in infiltration efficiency, especially in the upper jaw (PubMed; Cochrane). At Diplomat Med Center we use modern carpule anesthetics, and when needed — sedation; arsenic-based pastes are not used as they no longer meet current safety standards.
Diagnosis and planning: from X-ray to CBCT
Before treatment, the doctor evaluates complaints, performs clinical tests (cold/heat, percussion, palpation), takes periapical radiographs, and in case of anatomical complexity — 3D CBCT. The European Society of Endodontology (ESE) highlights the necessity of radiological confirmation of the diagnosis and control of key treatment stages (European Society of Endodontology Guidelines).
How root canal treatment is performed today
After isolating the tooth with a rubber dam, access to the chamber is created, canal orifices are located under a microscope and/or magnification, a glide path is established and mechanical instrumentation using nickel-titanium instruments is performed. Disinfection includes irrigation with sodium hypochlorite and EDTA with activation (ultrasound/sonic), improving microbiological control. Working length is determined by apex locator and X-ray. If necessary, calcium hydroxide is placed between visits as a temporary intracanal medication. Obturation is done using gutta-percha with bioceramic sealers (lateral compaction or warm vertical compaction techniques). Final stage — adhesive restoration, and in case of significant loss of tooth structure, a crown is recommended for crack prevention.
Prognosis and longevity of root-treated teeth
According to systematic reviews, primary root canal treatment ensures a high success rate: clinical and radiographic healing reaches 86–93% of cases when protocols are followed and coronal restoration is properly done (PubMed; PubMed). A key factor in long-term survival is final crown coverage: retrospective studies show a significantly higher preservation rate of teeth with full-coverage crowns (Aquilino & Caplan). The American Association of Endodontists also reports >90% success when standards are met (AAE).
When depulping is necessary and when it can be avoided
Indications include irreversible pulpitis, pulp necrosis, apical periodontitis, traumatic pulp exposure, and preparation of abutments for certain prosthetic rehabilitations. In early stages of caries and reversible pulpitis, biological pulp-saving treatments (direct/indirect pulp capping, bioactive cements) may be performed, as supported by ESE recommendations (ESE Vital Pulp Therapy).
Safety and postoperative period
Mild discomfort during chewing for 1–3 days is normal and is controlled with NSAIDs. The doctor provides recommendations regarding chewing load until final restoration, oral hygiene and recall timing. When technique is correct, complications are minimal; persistent symptoms require follow-up diagnostics and retreatment if necessary.
Root canal treatment at Diplomat Med Center
At Diplomat Med Center we provide endodontic treatment strictly according to international protocols, using rubber dam isolation, optical magnification, apex locators, mechanical instrumentation and activated irrigation. The exact plan is developed after digital diagnostics. After canal disinfection, we restore the tooth using adhesive materials and, when indicated, recommend a protective crown in collaboration with our restorative and prosthetic specialists. In case of severe soft tissue inflammation, periodontal specialists are involved, and to ensure long-term stability we recommend professional hygiene and remineralization.
Our clinic provides comprehensive tooth restoration, including caries treatment, adhesive restorations, placement of crowns or veneers when needed, preventive check-ups and AirFlow cleaning.
Make an appointment for root canal treatment at Diplomat Med Center today — we will eliminate the pain, preserve your tooth and restore chewing comfort with predictable and long-lasting results.