Root Canal Treatment in Single-, Two- and Three-Rooted Teeth
Root Canal Treatment in Multi-Rooted Teeth
Root canal treatment in single-, two- or three-rooted teeth is the cleaning, shaping and filling of root canals in pulp infection or irreversible pulpitis. Upper and lower molars usually have more than one root; anterior teeth are mostly single-rooted.
An important distinction: root number and canal number are not always the same. A root may contain more than one canal; the second canal in the mesiobuccal area of upper first molars (MB2) is one of the canals often missed. A missed canal may lead to treatment failure.
Anatomy and Imaging
Root canal curvature, narrow canals and calcification that increases with age may make the procedure more difficult. Periapical radiography is used for initial assessment; in complex anatomy, Cone Beam CT (CBCT) may selectively help identify an additional canal or lesion.
Microscope or magnification support may help find additional canal openings; the same equipment may not be available in every clinic.
Treatment Stages
Access to the pulp chamber is opened under local anaesthesia. Canal cleaning and shaping are performed with NiTi rotary or manual files. Sodium hypochlorite and EDTA irrigation help infection control.
Depending on infection severity, intracanal medication (calcium hydroxide) may be left between visits; treatment may be completed in one or several sessions. Obturation is performed with gutta-percha and sealer. Anaesthetic effect and post-procedure sensitivity may vary by person.
Restoration and Follow-up
After root canal treatment, the tooth may become fragile; especially in molars with large cavities, a protective restoration (crown or onlay) may be considered. An automatic crown indication is not valid for every case; remaining tooth tissue and occlusal load are assessed together.
Periodic radiographic review may be recommended to monitor apical health. If treatment fails, retreatment or apical surgery may be considered as alternatives.
Difference from Periapical Lesion and Retreatment
In teeth with periapical lesions, a radiological lesion at the root tip may be present; follow-up and prognosis are assessed separately. Retreatment is the removal of an old filling and renewed treatment in teeth with a previous failed root canal treatment.
All three indications require different planning and expectations. Mild chewing sensitivity may last for a few days after the procedure; severe or increasing pain requires assessment.
The seal of the upper restoration after root canal treatment is important for long-term success; a temporary filling should not be left for a long time.