Irreversible pulpitis occurs when bacteria have not yet entered the pulp cavity, but their toxins have, which cause a very strong and irreversible inflammation of the nerve. It presents with acute and spontaneous pain, which can become continuous, and which increases with changes in temperature (especially cold), chewing and postural changes (especially when lying down at night).

Tooth necrosis occurs when bacteria infect the pulp tissue. In these cases, the pain is usually sharp and intermittent, increasing with chewing, and is usually relieved by cold. In some cases, the bacteria manage to infect the surrounding tissues producing phlegmon, with swelling of the face.

Treatment has two main phases.
In the first place, the location, instrumentation and deep cleaning of the ducts. In cases of necrosis, on some occasions, we leave an intracanal medication for at least two weeks, to eliminate a greater amount of bacteria, thus improving the prognosis.
Second, and once the ducts are clean and shaped, we proceed to the obturation, which consists of introducing a material into the ducts to leave them properly sealed.

The prognosis of endodontics is around 90% success in cases of irreversible pulpitis, and over 80% in cases of necrosis.