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EndodonticsIntermediate

Root canal treatment, step by step

In root canal treatment, the inflamed or infected pulp is removed, the inside is cleaned and disinfected, and it is filled and sealed.
Molar with a rubber dam and the pulp chamber opened during root canal treatment.
Molar with a rubber dam and the pulp chamber opened during root canal treatment.Photo: GiulioArnaboldi · CC BY-SA 4.0, Wikimedia Commons

Step by step

  1. Diagnosis with tests and a radiograph.
  2. Anesthesia and isolation with a rubber dam.
  3. Opening (access): the crown is opened until the pulp chamber is reached.
  4. The pulp is removed, and the canals are cleaned and shaped with files while rinsing with irrigants.
  5. The canals are filled with gutta-percha and a sealer cement.
  6. The tooth is restored with a filling or a crown (sometimes with a post).

What you need to know

  • It is indicated when the pulp is inflamed or infected: deep caries, repeated dental work on the tooth, faulty crowns, cracks or trauma.
  • With anesthesia, it hurts no more than a filling. There may be mild discomfort for a few days.
  • It is usually done in 1 or 2 appointments, and with good care the tooth can last a lifetime.
Radiograph of upper teeth with the canals already filled: the white lines are the gutta-percha.
Radiograph of upper teeth with the canals already filled: the white lines are the gutta-percha.Photo: Captain Iglu · CC BY-SA 2.0 DE, Wikimedia Commons

Terms in plain words

Gutta-perchaA rubber-like material that fills the canals.
Endodontic fileA thin instrument for cleaning and shaping the canal.
Rubber damA rubber sheet that isolates the tooth from saliva.
Pulp chamberThe pulp space inside the crown.

For the exam

What material are the canals filled with?

Show answerHide answer

With gutta-percha and a sealer cement.

Sources

  1. American Association of Endodontists (AAE). What is a Root Canal? View source
  2. Hennessy BJ. Caries. MSD Manual, Professional Version (2026 revision). View source
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