scholarly journals Common Operative Procedural Errors and Clinical Factors Associated with Root Canal Treatment

2017 ◽  
Vol 28 (2) ◽  
pp. 179-190 ◽  
Author(s):  
Carlos Estrela ◽  
Jesus Djalma Pécora ◽  
Cyntia R.A. Estrela ◽  
Orlando A. Guedes ◽  
Brunno S.F. Silva ◽  
...  

Abstract Operative procedural errors must be well analyzed in order to avoid influence negatively the root canal treatment (RCT) prognosis. The successful RCT prevents tooth loss and avoids pain and apical periodontitis. This review aimed to categorize common operative procedure errors and clinical factors associated with RCT. Based on this, will be approached common errors of procedures within the clinical operative sequence: endodontic treatment planning, pulp and periapical disease diagnosis, anaesthesia, access cavity preparation, isolation with rubber dam, root canal preparation, root canal filling and retreatment, restoration of endodontically treated teeth, postoperative pain, follow up of endodontically treated teeth. The professional must remind that in each phase of RCT an operative error may have adverse implication on prognosis, and these errors characterize risk factors to failure. The knowledge of probable operative procedural errors and its consequences are essentials to avoid future problems to the tooth health.

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Kawther Bel Haj Salah ◽  
Sabra Jaâfoura ◽  
Mahdi tlili ◽  
Marwa Ben Ameur ◽  
Saida Sahtout

Introduction. Apical periodontitis is among the most common pathologies in endodontics. The treatment of apical periodontitis has always been an important occupation in the modern practice of endodontics, and the failure has been associated with nonhermetic root canal filling. With that in mind, bioceramic-based sealers have been incorporated into endodontic practice. The purpose of this study was to evaluate the outcome of nonsurgical root canal treatment (RCT), using a single-cone and Bioroot RCS filling of necrotic teeth with apical periodontitis. Materials and Methods. This follow-up study included patients treated in the department of Restorative Dentistry and Endodontics in the Dental Clinic of Monastir, from January 2018 to December 2019. The study intended to include all adult patients presenting a symptomatic or asymptomatic apical periodontitis. Once the diagnosis was performed, the patients were divided into two groups: a one-session treatment group and a two-session treatment group. All cases were obtured with BioRoot using a single-cone technique with a minimum of a 6-month recall. At 6-month follow-ups, teeth were classified as healed, healing (success), or not healed (failure), based on clinical and radiographic findings. Results. Twelve patients met the inclusion criteria, six patients per group. Seven patients returned for follow-ups. At 6-month follow-ups, the overall success rate was 100%, with 57.1% determined to be “healed” and 42.8% determined to be “healing.” All the PAI scores decreased compared to the baseline situation. Conclusion. The results obtained showed the contribution of BioRoot RCS in the healing of periapical lesions. Accordingly, bioceramic-based sealers seem to optimize the prognosis of root canal treatments.


2021 ◽  
Vol 32 (3) ◽  
pp. 127
Author(s):  
Lydiawati Wibisono ◽  
Hendra Dian Adhita Dharsono

Pendahuluan: Pulpitis ireversibel simtomatik ditandai dengan hipersensitivitas terhadap stimulus termal, yang menyebabkan nyeri spontan atau rasa sakit yang bertahan 30 detik atau lebih setelah stimulus dihilangkan, nyeri yang parah, persisten, dan sulit dilokalisir, dapat menjalar ke telinga, pelipis, mata atau leher. Kondisi pulpa yang terinflamasi tidak dapat kembali pulih dan perawatan saluran akar merupakan pilihan perawatan. Tujuan laporan kasus ini membahas mengenai perawatan saluran akar dengan pulpitis ireversibel simtomatik untuk menghentikan inflamasi pulpa dan mempertahan gigi. Laporan kasus: Pasien laki-laki berusia 35 tahun datang ke klinik dengan keluhan gigi belakang kanan bawah terasa sakit berdenyut sejak 1 minggu yang lalu. Gigi tersebut pernah dilakukan penambalan sementara 4 bulan sebelumnya dan tambalan tersebut patah serta nyeri spontan. Pemeriksaan radiologis gigi 46 menunjukkan gambaran radiolusen pada bagian mahkota hingga mencapai tanduk pulpa, terdapat 2 akar, dengan akar mesial dilaserasi ke arah distal dan akar distal lurus, serta saluran akar yang menghilang pada 2/3 dan 1/3 saluran akar distal dan mesial, tidak terdapat pelebaran membran periodontal, lamina dura normal dan tidak terdapat kelainan periapikal. Gigi 46 dilakukan anestesi lokal, dilanjutkan pembukaan akses dan ekstirpasi pulpa, kemudian preparasi saluran akar menggunakan nikel titanium rotary ProTaper Next® (Maillefer, Switzerland) dengan teknik crown down dan pengisian saluran akar. Restorasi follow up overlay komposit indirek pada gigi 46. Simpulan: Pulpitis ireversibel simtomatik pada gigi molar dengan akar dilaserasi terbukti dapat ditangani dengan perawatan saluran akar yang adekuat, ditandai dengan hilangnya keluhan pada pasien dalam kasus ini.Kata kunci: Pulpitis ireversibel simtomatik, perawatan saluran akar, teknik crown down. ABSTRACTIntroduction: Symptomatic irreversible pulpitis is characterised by hypersensitivity to the thermal stimuli, which causes spontaneous pain that lasts 30 seconds or more after the stimulus removed, severe, persistent and difficult to localise, can radiate to the ears, temples, eyes, or neck. The inflamed pulp does not recover; thus, root canal treatment is the treatment option. This case report was aimed to discuss the root canal treatment for symptomatic irreversible pulpitis to stop the pulp inflammation and preserve the teeth. Case report: A 35-year-old male patient came to the clinic with complaints of pulsating pain in the mandibular right molar since one week prior. The tooth had a temporary filling four months earlier, and the filling was fractured, and the pain was spontaneous. Radiological examination of tooth 46 showed radiolucent images on the crown until the pulp horn, there were found two roots, with mesial roots dilated distally and straight distal roots, and root canals that disappeared in the two-third and one-third of the distal and mesial root canals, no dilation of the periodontal membrane, normal lamina dura and no periapical abnormalities. Tooth 46 was subjected to local anaesthesia, followed by access opening and pulp extirpation, then the root canal preparation was performed using the ProTaper Next® rotary nickel-titanium (Maillefer, Switzerland) with the crown-down technique and root canal filling. Indirect composite overlay follow-up restoration was conducted of tooth 46. Conclusion: Symptomatic irreversible pulpitis in molars with dilacerated roots proved to be manageable with adequate root canal treatment, marked by the loss of the patients’ complaints.Keywords: Symptomatic irreversible pulpitis, root canal treatment, crown-down technique.


2019 ◽  
Vol 15 (4) ◽  
pp. 600-603
Author(s):  
Norazlina Mohammad ◽  
Faizah Abd Fatah ◽  
Norzalina Ghazali ◽  
Ahmad Zaim Muhamad ◽  
Nurhidayah Hamir

Root canal treatment (RCT) is a procedure to eliminate pulpal diseases with the aim to promote healing of the periradicular tissue. The RCT conducted must be of high technical standard and achieve a good quality endodontic work (GQEW) to ensure successful outcome and prolonged retention of the teeth in oral cavity. Previous studies reported poor outcome of RCT conducted by the undergraduate dental students. There is limited report documented on the quality of RCT performed by the dental students in Malaysia. The aim of this study was to identify the technical standards of the RCT and types of post-endodontic restoration placed by USIM undergraduate dental students. The radiographic obturation quality from 274 root filled teeth were evaluated against several indices. The data were analyzed using SPSS version 21. Post treatment radiographs indicated that 84.62% of the RCT have adequate density indicating good apical seal. Meanwhile, for obturation level, the root canal filling that ends 0-2mm (optimal), >2mm away (inadequate), and beyond apex (extrusion) were 84.59%, 5%, and 10.77%, respectively. Teeth with GQEW, having both adequate root filling length and complete obturation were found in 194 (74.6%) teeth. McNemar’s test revealed significant reduction in post-treatment periapical index (p<0.001) indicating good periapical healing. Permanent restoration was only placed in 48% of the teeth. In conclusion, the RCT conducted by USIM undergraduate dental students have a good technical standard. Placements of post-endodontic permanent restoration need to be emphasized in the curricular to ensure long-term success of the endodontically treated teeth.


Author(s):  
Giulia Bardini ◽  
Laura Casula ◽  
Emanuele Ambu ◽  
Davide Musu ◽  
Montse Mercadè ◽  
...  

2017 ◽  
Vol 46 (5) ◽  
pp. 255-260
Author(s):  
Caroline Garcez MENDONÇA ◽  
José Rogério Vieira de ALMEIDA ◽  
Wilton Mitsunari TAKESHITA ◽  
Fábio MARTINS ◽  
Monica Silveira PAIXÃO

Abstract Introduction Endodontically treated teeth with extensive coronary destruction require posts and cores to enable prosthetic restoration. Despite the increasing use of prefabricated posts, cast metal posts and cores are still widely used. The quality of the latter is important for the longevity of restorative treatment, and failure can occur if the fundamental principles are not followed. Objective To radiographically evaluate the prosthetic principles of 1000 cast metal post-and-core restorations performed in single-rooted teeth and their coherence with the principles used for their confection. Material and method Digital periapical radiographs of 1000 endodontically treated, single-rooted teeth with cast metal posts and cores were selected from the collection of a radiology clinic (Centro de Imagem, Aracaju/SE, Brazil). The images were analyzed using a measurement software (ImageJ, USA) in accordance with the fundamental prosthetic principles: length and diameter of the post, ratio between post and bone crest, contiguity of post to the root canal, gap between post and the remaining root canal filling, amount of remaining root canal filling, and absence of periapical lesion. The data were qualitatively analyzed, classified into ideal and not ideal, and submitted to the chi-square test (α=0.05). Result Only 6.7% of the cast metal posts analyzed were satisfactorily fabricated. Conclusion Many prosthetic criteria are neglected during the manufacturing of cast metal post and cores, resulting in inadequate work that may compromise the longevity of restorative treatments.


2016 ◽  
Vol 10 (1) ◽  
pp. 733-738 ◽  
Author(s):  
Leopoldo Cosme-Silva ◽  
Breno Carnevalli ◽  
Vivien Thiemy Sakai ◽  
Naiana Viana Viola ◽  
Leon Franco de Carvalho ◽  
...  

Background: Iatrogenic complications such as accidental perforation of the root or the floor of the pulp chamber may occur. Case Report: Patient was referred for root canal retreatment of the mandibular left second molar with periapical lesion evidenced through radiographic examination. During post removal, iatrogenic perforation occurred at the mesial face of the distal root. After clinical localization of the perforation and bleeding control, MTA was applied. In a second appointment, the root canal filling was removed and the chemical-surgical retreatment of the canals was performed, followed by the obturation with gutta-percha and sealer. Patient returned after three days reporting no pain. After 6 months, 3, 7 and 10 years of follow-up. Conclusion: Absence of pain, normal periodontal probing and lack of radiolucent area at the region of perforation and the periapices were detected, which evidenced the successful repair of the tooth.


2020 ◽  
Vol 23 (1) ◽  
Author(s):  
Julia Machado Saporiti ◽  
Andressa Gomes ◽  
Melissa Feres Damian ◽  
Nadia De Souza Ferreira

Objective: The aim of this study was evaluate radiographically prevalence of apical periodontitis (AP) in endodontically treated teeth (ETT) and relate with demographic factors, quality of endodontic treatment and coronal restoration. Material and methods: Data were collected from dental records wich contained full-mouth radiographic series. In ETT, arch, dental group and presence of AP were evaluated. Quality of root canal filling, presence and quality of coronal restoration and type of restorative material were also collected. Data were evaluated using descriptive statistics and Chi-square Test. Results: Of 70 patients included in the final sample, the majority were female (54.3%) and age ranged from 13 to 77 years (47.14 ± 13.18). Of 1,333 teeth evaluated, 73 (5.4%) had endodontic treatment, being the majority maxillary (74%) and anterior teeth (52.1%). Of teeth without endodontic treatment, 320 (25.4%) had AP. Failure rate was high (52.8%) and quality of root canal filling and coronal restoration were considered inadequate in majority cases (58.3% and 47.7%, respectively). Dental group had a statistically significant relationship with presence of AP in ETT, being more frequent in anterior teeth (p = 0.019). Conclusion: It was concluded that prevalence of AP in ETT was high and dental group was the factor that most influenced prevalence of AP in ETT.KeywordsApical periodontitis; Radiography; Root canal filling.


2012 ◽  
Vol 23 (5) ◽  
pp. 608-611
Author(s):  
Ronaldo Araújo Souza ◽  
Yara T. Corrêa Silva-Sousa ◽  
Suely Colombo ◽  
Maurício Lago ◽  
Marco Antonio Hungaro Duarte ◽  
...  

Besides the risk of filling material extrusion throughout the apex, a satisfactory apical seal can be difficult to achieve in canals with open apices or iatrogenic enlargements of the apical constriction. These situations pose a challenge to root canal filling. This paper describes the root canal filling of a maxillary right canine with an overinstrumented apex, complete loss of the apical stop, extensive canal transportation and apical periodontitis. A 5 mm calcium hydroxide apical plug was placed before root canal filling. The plug was made by soaking paper points with saline, dipping the points in calcium hydroxide powder and then applying it to the apex several times, until a consistent apical plug was obtained. The canal was then irrigated with saline in order to remove any residual calcium hydroxide from the root canal walls, dried with paper points and obturated with an inverted #80 gutta-percha cone and zinc oxide-eugenol based sealer by the lateral condensation technique. An 8-year radiographic follow-up showed formation of mineralized tissue sealing the apical foramen, apical remodeling and no signs of apical periodontitis.


Sign in / Sign up

Export Citation Format

Share Document