The most common diseases of the teeth develop in a certain sequence: caries -> pulpitis -> periapical periodontitis (granuloma)-> radicular cyst. Each of these diseases develops based on untreated predecessor. For example, pulpitis develops as a result of an untreated caries, an untreated pulpitis leads to a periapical periodontitis, while untreated periapical periodontitis causes a radicular cyst. In caries the hard dental tissues of the crown of the tooth are affected and treatment is through restoration.
In pulpitis, periapical periodontitis and radicular cysts the damage is caused by bacteria which have reached the nerve of the tooth and spread to the area around the tooth root and the supporting bone. The method of treatment of pulpitis and periapical periodontitis aims to relieve pain, to remove inflamed or necrotic pulp, which is left in the root canal and to prevent the occurrence of complications of the periodontium and development of cysts and granulomas. The main treatment method is endodontic (root canal) treatment. This constitutes cleaning of the root canals from the inflamed or necrotic nerve and filling them with special pastes and pins, which seal the interior of the tooth, and thus stop the entry of bacteria to the bone.
In pulpitis the infection is localized to the root canal of the tooth and does not pass into the bone, therefore a removal of the inflamed nerve and filling of the root canal is enough for achieving complete recovery – endodontic treatment.
In periapical periodontitis and radicular cysts, the endodontic treatment is a stage in the overall treatment. Besides the inflammation in the root canals, the inflammation that has spread to the bone needs to be treated. This is done by various therapeutic drugs. And in some cases by surgery.
In a good general state of the body, proper diagnosis and quality treatment, the pulpitis and the periapical periodontitis can be healed and the tooth can be saved, while in some cases, where there is severe inflammation, the removal of the tooth is necessary.
The detailed treatment of pulpitis, periapical periodontitis (granulomas) and cysts has been described in the following articles:
Root canal treatment of pulpitis
The treatment of pulpitis is called endodontic treatment (root canal treatment).
Treatment of periapical periodontitis
The treatment of periapical periodontitis is a difficult and responsible task.
Apical osteotomy and Hemisection
Apical osteotomy is a surgical procedure that is performed.