Devitalization or filling?

Root canal treatment and   filling are two so-called conservative  dental procedures  , i.e. aimed at healing a dental infection while avoiding more drastic interventions such as the extraction of the diseased tooth . Both root canals and fillings are considered routine dental procedures, as they are routinely performed on  decayed teeth .

But what’s the difference? Why and on what occasions is it necessary to resort to devitalization rather than filling a tooth?

Throughout the article we will try to highlight the characteristic elements of each intervention, also and above all focusing on the differences.

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Generality

Given that root canal treatment and filling are included in the list of conservative interventions, let’s see in detail for what purpose they are performed.

Devitalization

It is a dental procedure aimed at destroying and removing the  pulp of a tooth  seriously damaged by extensive cariogenic processes,  dental pulp infections  or high-grade trauma. After removing the diseased pulp from the previously anesthetized tooth, the devitalization proceeds with the sealing of the pulp canal using specific biocompatible materials or cements: this procedure is essential to protect the tooth from a possible spread of the infection into the adjacent dental tissues.

the various stages of dental devitalization are:

1. Sick or damaged tooth
2. Drilling and cleaning
3. Elimination of vesselsand nerves up to the apex of the tooth with root canal files (endodontic “files”)
4. Filling with gutta-percha and covering with prosthetic crown (capsule).

Filling

Also called  root canal filling , fillings are commonly performed to restore  teeth  affected by superficial or moderate-grade caries. This procedure guarantees the total restoration of the structure, morphology and integrity of the infected tooth.

After anesthesia, the decayed tooth is healed through the removal of the dental caries, always performed with special burs; subsequently, the groove created is adequately filled with specific amalgams or resins.

Comparison

At this point some questions arise spontaneously: why can’t decayed teeth always be healed through a simple filling? In what circumstances is root canal treatment necessary?

Basically, the choice of one intervention rather than another is established on the basis of the severity of the underlying dental infection. Both dental procedures can be performed to restore the structural integrity of a tooth infected with caries: what makes the difference is the depth of the cariogenic process. Superficial caries or caries that go as far as the  dentin are generally healed by simple filling: in these cases the dental pulp is not involved, therefore the tooth preserves and maintains its complete vitality.

Otherwise, a deep and particularly extensive caries beyond the dental pulp (pulpitis) cannot be treated through a simple filling: in such situations, devitalization is the treatment of first choice.

Directions

Caries is not the only dental infection that can be treated by root canal or filling. The table lists (in alphabetical order and not of importance) the dental pathologies that can be treated with these interventions.

Carious wisdom tooth

One of the priority objectives of modern dentistry is to protect the integrity of decayed or infected teeth for as long as possible through fillings, root canals or other conservative practices (eg apicectomy  , in case of  dental granuloma  or  cyst ). However, what has been said is not generally applied in some precise circumstances: this is the case of wisdom teeth. Generally, when one of the third molars is involved in infectious processes – whether simple caries or more serious infections – the dentist suggests the extraction of the tooth. In fact, it would not make sense to proceed with a filling or a root canal to keep the wisdom toothin its natural position, this being almost useless for the purposes of chewing and the aesthetics of the smile. But that is not all. Many dentists recommend  extracting wisdom teeth  even if they are in perfect health conditions (especially if  they are included ): the aim is to prevent any possible future ailments, first of all  crooked teeth  or  dental malocclusion .

Conclusions

The decision to restore an infected tooth by root canal or filling is up to the doctor alone. Before proceeding with an operation, the specialist must in fact consider the patient’s state of health, the severity of the infection and any requests from the client, and therefore act accordingly.

After a root canal or a filling, the dentist will have to carefully educate the patient on the correct behavior to follow in order to minimize the risk of post-surgery complications.

To conclude, we remind you that a correct  pluridaily oral hygiene (carried out with regular expertise using a toothbrush ,  toothpaste  and  dental floss ), supported by  professional dental cleaning  every 6-12 months, is an intelligent prophylactic strategy to preserve the  health of the teeth . In this way it is possible to escape from dental operations such as root canals and fillings which, although simple and relatively painless, always feed discomfort and tension in the patient.