About the treatment of pulpitis three-channel teeth and prices for this procedure

First of all, we note that the price for the treatment of pulpitis of a three-channel tooth really depends on the number of these root canals in it, and here the general rule is this: the more of them, the more usually the treatment procedure costs more. And not only more expensive, but, in addition, with a large number of roots, quite often there are also a number of nuances of carrying out endodontic procedures, which we will discuss in more detail later.

On a note

Pulpitis - This is a disease in which there is inflammation of the so-called dental "nerve" (pulp). Large molars (molars) often have three channels, in each of which there is a neurovascular bundle. When an inflammatory process occurs in the pulp, it swells and is compressed, as a result of which a person may experience severe pain.

Pulpitis requires compulsory treatment: one should not expect that everything will somehow resolve, and the pain will go away on its own, as is sometimes the case with pain caries. The pain can really disappear when the “nerve” completely dies, but then it will begin to decompose right inside the tooth, and without good treatment it will not lead to anything good.

The treatment of pulpitis of a three-channel tooth, in contrast to a single-channel tooth, is more often technically more difficult, therefore, a doctor has to spend more time and effort to carry out quality work, and also actively apply the achievements of modern dentistry.

Today, in most clinics, three-channel pulpitis is almost always treated by extirpation - nerve extraction from all channels and their filling at the final stage of intracanal treatment.

It is interesting

In the upper wisdom teeth, there are the most unpredictable variants of the number and location of the roots and channels. As a rule, doctors face one-, two-, and three-channel eighth teeth, but cases of 4 and even 5 molar teeth were recorded with up to 8 full-fledged channels in it!

 

The main stages of the treatment of three-channel pulpitis

Three-channel pulpitis in most dental clinics is treated in two visits. For these purposes, the technique of the so-called vital extirpation is well-suited, when pulp is removed from all three channels under local anesthesia and their filling is followed by placing a temporary filling material on the tooth. And on the second visit, a permanent filling is safely established.

Let's now see how this happens in practice.

First visit:

• tooth anesthesia;
• preparation by the turbine tip of carious softened tissues, removal of necrotic and pigmented dentin;
• washing with antiseptics;
• opening of good access to the mouths of the three channels;
• expansion of the mouths;
• cofferdam overlay;
• extirpation (extraction) of pulp from all three channels by pulpoextractors;
• passing channels with files, measuring their length, expanding with K-files, H-files, machine tools with constant irrigation (washing) of the system of channels with sodium hypochlorite solution;
• the use of drugs EDTA for poorly passable channels;
• drying of channels, control measurement of their lengths;
• canal filling with cold lateral condensation of gutta-percha dowel pins with paste or the use of the Termafil system forobturation;
• staging temporary fillings or temporary restoration of the tooth;
• control picture (radiograph).

Second visit:

• re-treatment of the tooth;
• setting a permanent seal of a light-cured composite or other imported material (an example will result in the photo below).

Sometimes pulpitis of the three-root tooth is treated in three visits and even more. It depends on the chosen technique, tactics of the doctor, the level of his professional skills and sometimes on the difficulties arising during the intracanal treatment.

If it is impossible to immediately remove the pulp from the canals, the dentist places a devitalizing preparation on the opened pulp chamber in order to “kill the nerve” to the next reception. Accordingly, this increases by one visit the treatment of three-channel pulpitis.

In Soviet times, even arsenic was placed on a single-channel pulpitis for a period of 24 hours. Such practice at the modern level of development of dentistry is already unacceptable. Treatment of pulpitis single-channel tooth, as well as the two-channel, almost always carried out in one visit (with rare exceptions).

Large molars (mainly lower) due to the peculiarities of the jaw structure and the location of the nerves,determining the sensitivity of the tooth, sometimes they can not “freeze” to the extent that you can immediately remove the nerve, that is, pain sensitivity remains. Therefore, a preliminary use of pastes that kill the pulp becomes the way out of this situation (they are still called “arsenic” by the people, although modern drugs no longer contain arsenic).

On a note

In a number of clinics treatment of pulpitis always carried out in one visit, regardless of the number of channels: they are sealed, and a permanent seal is immediately installed on the tooth. Studies have proven that this practice often leads to long-term negative consequences, since the material entered into the channels must first solidify. In construction, they do not start work until the foundation hardens, since the consequences can be dire - and here the situation is the same. That is why it is recommended to carry out the treatment of pulpitis at least in two visits.

 

The use of a microscope in the treatment of pulpitis

Microscope in endodontics is used, in particular, to diagnose the number of root canals and the quality of their passage. Treatment of pulpitis of a three-root tooth under a microscope allows you to quickly find and treat even the most impassable canals, and there are many such cases in the practice of the dentist.

The endodontic microscope makes it possible to say with almost 100% confidence at the end of the treatment that all the channels have been passed and properly sealed. It is he who allows to control each stage of the treatment of pulpitis, warning further development of complications. Traditional treatment without the use of a microscope is often associated with the presence of long-term negative effects, for example, because the doctor simply did not see the additional channel in the tooth and missed it during treatment, leaving the infected pulp in it.

Sometimes, in the treatment of pulpitis, the doctor finds 3 channels, and in fact there is a “well-hidden” 4th (or even fifth) tooth in the tooth. There are cases of missing not one channel, but several, as there are complex variants of their location in the tooth.

It is interesting

For the treatment of canals, the microscope was first used recently - in the USA (1992).A modern endodontic microscope makes it possible to treat teeth under magnification almost 30 times. During the procedure, the doctor looks through the eyepiece of the microscope and produces complex manipulations in the channels. A video camera can be connected to the microscope, which allows you to transfer an image to a monitor. The doctor is not too close to the patient, as the microscope helps to treat the tooth somewhat remotely, which satisfies those patients who do not like to get into their personal space. This treatment is considered one of the most progressive in the world.

The high price for treating pulpitis of a three-channel tooth can scare away patients even with normal income, since there can be two or even three times more traditional treatment options (imagine how things were going with the treatment of four-channel pulpitis). However, such a higher price is often fully justified, taking into account the specifics of complex and long-term endodontic treatment, so you should not immediately think that you are trying to cheat and lure money.

 

What is the price for the treatment of three-channel pulpitis?

First of all, we note a characteristic momentconcerning the pricing policy of most clinics for the treatment of pulpitis - the cost depends on each channel found in the tooth. The fact is that each channel is an additional time-consuming work of a doctor and additional costs of materials.

For example, a person in the tooth instead of one channel may be three, four or more. Therefore, it is not difficult to guess that the price for treating a three-channel or four-channel pulpitis consists primarily of the amount of work done by the doctor: the passage of canals, their irrigation (washing), expansion, sealing ...

The cost of treatment of pulpitis also includes:

• Local anesthesia;
• Additional instrumental methods of monitoring and channel therapy: apexlocation (determination of length), X-ray examination, ultrasonic or laser treatment, irrigation, use of a microscope, placement in the canals of temporary medicines for dressings, etc.
• Permanent filling material. After sealing the canal in the next visit, the doctor sets the permanent seal that the patient chooses, focusing on the acceptable price for him.

With that said, it becomes quite obvious that, regardless of the dental institution where the patient turns for help, the treatment of pulpitis of a single-channel tooth will cost much less than a three-channel tooth.

It is interesting

One channel in 100% of cases there is in the upper incisors and canines. Moreover, in the canines most often the channel is very wide and long. In the lower incisors, there is mainly one channel, but not infrequently there are two. Only in 6% of cases, the lower canine is two-channel, and in the rest - single-channel. The second premolar (5 upper and lower teeth) in more than 70-80% of cases have one canal.

 

Different clinics - different cost of services: for what exactly do you pay money?

Depending on the "price-quality" indicator for the services provided, all dentistry can be divided into three categories:

1. Budget organizations (polyclinics, hospitals);
2. Private clinics of economy class;
3. Private clinics business class.

Advantages of a budget organization:

• Free treatment or low price for services (as a rule, only the cost of paid materials is taken into account);
• You do not need to sit in a chair for a long time, as quickly as possible.

Minuses:

• In general, the quality of services is relatively low due to the constant rush of the doctor, insufficient technical equipment, lack of materials and often the professionalism of the dentist.
• Long waiting in lines, where you can often hear such that any desire to go to the doctor will disappear.
• Rudeness and poor attitude towards the patient - this, unfortunately, is not uncommon in many clinics and hospitals.
• There is no guarantee for the performed canal treatment and for a permanent filling.

As a result of poor-quality treatment of three-channel pulpitis in the budgetary organization, in a short time the following problems may arise:

• pain in the tooth on the background of poorly washed, under-filled canals or as a result of removing the filling material beyond the root (it will hurt to bite);
• swelling of the gums and cheeks in case of missing channels (with infection) or a fragment of a dental instrument left in the canal, which is also not uncommon (see photo below);

and etc.

The mistakes of the budget doctor can be transferred endlessly, but it is worth remembering that there are quite a few doctors even in hospitals and clinics,which are provided with material and have a high level of professional skills, allowing to carry out treatment of at least three, at least four-channel pulpitis at a sufficiently high level, although today it is rather an exception to the rule.

The advantages of a private clinic economy class:

• Availability of services for the population with average incomes;
• Lack of large queues;
• As a rule, a fairly high professional level of the doctor;
• Availability of necessary equipment and materials for the implementation of economy class services;
• Warranty on canal treatment and filling.

Minuses:

• The lack of maximum quality control of treatment at all stages (the risk of complications after canal filling can be described as medium);
• Not good enough for artistic restoration materials, which often do not allow to make a seal completely invisible to the eyes of others.

A private business-class clinic, in contrast to the previous options, allows us to provide very high-quality services due to the availability of modern equipment and highly trained qualified dentists.

The use of a microscope as an intermediary between a doctor and a patient’s tooth significantly increases the already considerable price for the treatment of pulpitis of a three-channel tooth. However, thanks to this equipment, the patient can forget for a lifetime that the treatment was once carried out in the canals of his tooth, and it only remains to come to the dentist to inspect the condition of the filling.

Often there are situations when the patient, after contacting the local clinic, after a year or two loses a tooth because root cyst, and as a result, an expensive prosthetics of the missing tooth costs even higher than the treatment of three-channel pulpitis, but in a business-class clinic.

There are also such cases when, for example, 5-7 years after the treatment of pulpitis in an economy-class clinic (approximately 6-7 thousand rubles), it is found that a huge granuloma developed at the root of a piece of instrument left in the root, due to which tooth is not possible to save. In such a situation, it is already difficult to tell the patient what is best for him: to lose a tooth in 5-7 years and deal with its expensive prosthetics or implantation, or immediately go to a business-class clinic, where the treatment of pulpitis of a three-channel tooth will cost around 12-14 thousand rubles, but such a tooth will last for the rest of your life.

 

Interesting video: treatment of pulpitis of the upper tooth, which was not three-channel, but 4

 

And here you can see all the stages of treatment of pulpitis, including filling