Root canal treatment + zirconia inlay (UL5)

Inside every tooth is a soft core — the pulp — containing nerves and blood vessels, housed in a system of narrow canals. When deep decay, a crack, or trauma lets bacteria reach the pulp, it becomes inflamed or infected, which causes pain and, untreated, can spread to the bone around the root.

Root canal treatment removes the infected pulp, disinfects and shapes the canal system, and seals it — so the natural tooth can stay in function instead of being extracted. Keeping your own tooth preserves the bone and bite in a way no replacement fully matches.

What separates a careful, modern root canal from a rushed one is largely technology and protocol: 3D imaging to see the anatomy, isolation to keep the field clean, flexible instruments to follow curved canals, and biocompatible materials to seal. The steps below are how we do it at RODIN.

Treatment begins with diagnosis. A cone-beam CT (CBCT) scan captures the three-dimensional shape of the root canal system — additional canals, C-shaped configurations, and lateral canals that a conventional 2D periapical radiograph can miss.

The endodontic imaging literature reports that CBCT detects canal anatomy and periapical findings that 2D radiographs do not always reveal, which helps plan the treatment accurately before it starts and reduces the chance of a missed canal.

The tooth is isolated with a rubber dam — a thin sheet that seals the working field from saliva and oral bacteria, and also protects you from the irrigating solutions used to disinfect the canals.

Rubber-dam isolation is the international standard-of-care protocol for infection control during root canal treatment, and studies associate its use with improved outcomes. It is a small step that makes a large difference to how clean the canal system can be kept.

A small, conservative access cavity is prepared to reach the pulp chamber and locate the canal orifices, removing as little healthy tooth as possible while still giving the instruments a clear path into the canals.

The canals are cleaned and shaped using nickel-titanium (NiTi) rotary files. NiTi is far more flexible than stainless steel, so the files follow curved canals more faithfully and stay centred rather than straightening the canal.

The endodontic literature reports lower rates of procedural errors (such as canal transportation) and efficient shaping with NiTi compared with traditional stainless-steel hand files. Researchers who have studied NiTi instrumentation extensively include Plotino and colleagues, publishing in journals such as the International Endodontic Journal and the Journal of Endodontics.

Shaping alone does not disinfect a canal — irrigation does much of the cleaning. The canals are disinfected with an irrigation protocol: typically sodium hypochlorite (NaOCl) to dissolve organic tissue and kill bacteria, followed by EDTA to remove the smear layer that shaping leaves behind.

Thorough irrigation reaches the fins and isthmuses that a file cannot, so the canal walls are genuinely clean before the space is filled.

Once cleaned and shaped, the canals are filled (obturated) — most often with gutta-percha and a sealer — to seal the space three-dimensionally and help prevent bacteria from re-colonising it.

Where a perforation repair or an apical seal is needed, we use MTA (mineral trioxide aggregate). MTA — extensively characterised by Torabinejad and colleagues — is highly biocompatible and provides a superior seal compared with many traditional cements, as reported in the endodontic literature (e.g. the Journal of Endodontics). It can even set in the presence of moisture, which makes it valuable deep in the root.

A root-treated tooth is structurally weakened and often more brittle, so it is normally protected with a final restoration — a crown, or an inlay/onlay — to restore function and substantially reduce the risk of fracture.

Restoring the tooth promptly after the canal work is an important part of the long-term result; a well-sealed canal can still be compromised if the crown above it is left unprotected and leaks.