Three years ago I had a tooth treated because of recurrent granulomas. Every time the tooth was closed, the granulomas worsened. In the end the situation could no longer be resolved and the tooth had to be extracted. How much does the success of treatment depend on the equipment, on the choice of dentist and on what equipment they use? How can I make sure that next time I will be treated using the most modern equipment? I have the impression that the most modern methods are available only from private dentists (self-pay).

The success of endodontic treatment depends on many factors. First and foremost, on the condition of the tooth or periodontal tissues at the time when therapy begins. In the case of treatment of inflammation of the dental pulp (i.e. a diagnosis of pulpitis), which the patient experiences as severe pain in a tooth that has appeared for the first time, the prognosis of treatment is fairly good. If the tooth was already affected some time ago and pain has reappeared, we assume that we are dealing with a tooth that has been non-vital for a longer period. In this case we treat what is known as gangrene of the dental pulp. Bacteria have already colonised the root canals and have probably also damaged the periodontal tissues in the area of the root apex. Treatment in this case is considerably more prolonged, and the prognosis substantially poorer.
As far as the quality of treatment by different dentists is concerned, I believe that everyone makes a great effort, while the treatment method is in any case determined by professional doctrine. Equipment for root canal treatment, however, differs considerably from one practice to another. Today we cannot imagine good root canal treatment without the ongoing use of an X-ray unit, an apex locator for determining root canal length, a rubber dam to protect the operative field and, finally, an operating microscope that enables us to locate microscopically small entrances to root canals. Using all of this requires a great deal of time. All of the above is of course associated with substantial costs, which in our experience the insurer will never cover.