The devitalisation (alias endodontic therapy, alias root canal therapy) is a branch of dentistry which deals with the treatment of dental tissues: dental pulp or nerve (inappropriate but very common expression). The endodontic therapy consists in the total removal of all structures as a whole (amputation) and in filling all the empty spaces (endodontium) of the dental clinical crown (pulp chamber) and roots (root canals).

It's a matter of microsurgery and for this reason the use of the stereo microscope is essential. The real top level specialist or endontist (a professional dentist who dedicated his entire life to this discipline) presents the benefit of a remarkable number of operating case histories. This allows the shortening of operating timings (60 min against 120-180 min of a general dentist for the treatment of a molar), to drop the rate of failures (2-3%) and an extremely microscope-focused procedure.

If there is not enough tooth structure to properly retain the traditional prosthetic crown, the tooth requires a build-up material. This can be accomplished with a pin-retained direct restoration, such a composite resin, or in more severe cases, it may require a post & core. Should the tooth require a post and core, endodontic therapy would then be indicated, as the post descends into the devitalized root canal for added retention. If the tooth, because of its relative lack of exposed tooth structure, also requires crown lengthening, the total combined time, effort and cost of the various procedures, together with the decreased prognosis because of the combined inherent failure rates of each procedure, might make it more reasonable to have the tooth extracted and opt to have an implant placed.

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