This is an endodontic treatment approach applied when infection and tissue loss occur at the tip of the tooth root or in the surrounding bone tissue. These lesions usually develop as a result of long-term infection of the dental pulp, untreated deep caries, or failed previous root canal treatments. Once a lesion forms, the infection is no longer limited to the inside of the tooth; it spreads from the root tip into the jawbone, where an inflammatory reaction develops. The primary goal of root canal treatment is to completely remove the infected tissues inside the tooth and stop this spread.
Root canal treatment in teeth with lesions is not performed solely to relieve pain. It also aims to re-establish a suitable biological environment that allows bone tissue to regenerate. With properly performed root canal treatment, the body can gradually repair the affected area and new bone formation may occur. This process enables the tooth to continue functioning in the mouth. Preserving the natural tooth instead of extraction is one of the primary treatment principles in modern dentistry.
Why Is Root Canal Treatment Necessary in Teeth with Lesions?
The main reason root canal treatment becomes necessary in a tooth with a lesion is that the infection has reached a level that can no longer be controlled by the tooth’s natural defense mechanisms. When the dental pulp loses vitality, the inside of the tooth becomes a favorable environment for bacteria. Over time, these bacteria exit through the root tip and cause inflammation in the surrounding bone tissue. The lesion is a result of this process and indicates that the infection is actively ongoing.
In such cases, painkillers or temporary measures are not sufficient. The source of the infection lies within the tooth, and unless this source is eliminated, the lesion will continue to progress. Root canal treatment removes the infected tissues and seals the root canals in a hermetic manner, preventing bacterial recolonization and allowing the immune system to begin repairing the affected area. Therefore, root canal treatment in teeth with lesions is a fundamental approach that should not be delayed.
Problems That May Occur If Root Canal Treatment Is Not Performed
If root canal treatment is not performed on a tooth with a lesion, the infection may progress and spread to surrounding tissues over time. Initially, this process may advance silently, but in later stages it can manifest as severe pain, facial swelling, and abscess formation. The infection may extend beyond the bone tissue to soft tissues and, in rare cases, even into systemic circulation, posing a risk to overall health.
Untreated lesions lead to progressive bone loss. Continuous resorption of bone at the root tip causes the tooth to gradually lose its supporting structures, eventually making extraction unavoidable. Additionally, neighboring healthy teeth may also be affected by the infection. Delaying root canal treatment may result in the need for more extensive and costly procedures.
Session Planning in Root Canal Treatment for Teeth with Lesions
Root canal treatment in teeth with lesions is often not completed in a single session. The extent of the infection, the size of the lesion, and the anatomical structure of the tooth are the main factors determining the number of sessions. In most cases, treatment is planned over two or more visits. During the first session, infected tissues are removed, root canals are shaped, and disinfection is achieved using temporary intracanal medications. This step is critical for reducing the bacterial load.
In subsequent sessions, the control of the infection is evaluated, the effect of intracanal medications is assessed, and when appropriate, the root canals are permanently filled. In cases of large lesions, the healing process is monitored more closely and the number of sessions may be increased. This controlled approach is essential for lesion regression and long-term retention of the tooth in the mouth.
Healing Process of the Lesion After Root Canal Treatment
Healing of the lesion after root canal treatment is a biological process that occurs gradually over time. Once the source of infection is eliminated, the body begins to remove the inflamed tissue at the root tip and regenerate bone tissue. Although healing may begin within weeks, radiographic evidence of recovery may take several months or even up to a year in some cases. The size of the lesion and the patient’s immune system are important factors influencing this process.
Not all lesions heal at the same rate. Smaller lesions tend to resolve more quickly, while cases involving extensive bone loss may require a longer healing period. Regular follow-up radiographs are used to monitor healing. When root canal treatment is performed correctly and the tooth is properly restored, most lesions can heal completely. However, patience and regular follow-up are essential.
Frequently Asked Questions About Root Canal Treatment in Teeth with Lesions
Is root canal treatment necessary even if there is no pain?
Pain may not always be present in teeth with lesions. Absence of pain does not indicate absence of infection and does not eliminate the need for treatment.
Can lesions heal with antibiotics alone?
Antibiotics may provide temporary relief but do not eliminate the source of infection. Root canal treatment is required for a permanent solution.
Can the lesion recur after root canal treatment?
When root canal treatment is performed properly, the risk of recurrence is low. However, recurrence may occur if the seal is compromised or a new infection develops.
Can teeth with lesions be treated without extraction?
Many teeth with lesions can be successfully treated with root canal therapy without extraction. With proper evaluation, the tooth can remain functional for many years.
Author: Dt. Niran Uluçay