Root Canal Treatment Failures are becoming the 3rd most common cause of tooth extraction after Caries and mobility. With the increase in root canal treatment failures it becomes the duty of Dentists to make sure that root canal treatments are undergone with proper care and by following the proper technique like
- Maintain Proper Sterilization
- Use X-ray to determine the Working length and an X-ray to confirm it at the end
- Do not try to cover up your mistakes be clear with the patient and give them the best treatment required
- Do not do RCT on teeth which are not in a position to take up RCT and a Crown – Contraindications of Root Canal Treatment
These are some of the reasons i have mentioned and there are many more precautions to be taken which i will be updating in the next post.
Some pics of Root Canal Treatment Failures –
This is an extreme case of Root Canal Treatment Failure where a number of GP points were pushed Peri Apically and left like that. when the patient experienced Pain in the same region he/she went to another dentist who took an Xray to see this. In cases like this Extraction is the only procedure which can be performed.
This is an entirely Opposite case to the above one, here we can see in the Xray that there has been Under extension of the GP points and due to which there is a persistent Peri Apical Lesion. This is a case of Faulty BMP and Obturation technique, Where i think the dentist might not have taken an Xray at the end of the procedure to evaluate the treatment done.
This is Another case of Under Extension of Gutter percha points leading to persistence of peri-apical micro organisms causing peri-apical pathology. Under extension of cases is a result of improper instrumentation and a result of not taking Working length X-rays or the use of Apex Locators to determine the correct working length which can eliminate the under extension of GP points.
This is one another blunder in doing RCT where the gutta percha was inserted into the bone and not the root canals wonder how a Dentist could do such a treatment and then seal it with Restoration. The only solution to such cases is Extraction of the Tooth infected and replacing it with an Dental Implant of a Bridge.
This Dentist must be given an Award for this kind of BMP and Obturation extending into the adjacent tooth. This obturation left the root canal, not even under extension or over extension but it has extended into the adjacent tooth by extending through the inter dental bone. Such Obturations lead to Perforations which leads to bad prognosis and might require using
To avoid such failures it is best to leave Root Canal treatment to the Experts (Endodontists) just refer the patient or you can call an Endodontist to your clinic. This will prevent any future embarrassment to you and also provide the best treatment plan to the patients who have trusted you. For a RCT to be successful you need to follow all the steps and give sufficient team for any periapical lesions to subside if necessary – Diagnostic X-ray, Access Opening, Working Length determination, BMP, Obturation and Restoring it with a Crown.