Success / failure in endodontic treatment

Question 1

When should ew assess a root canal treatment we have carried out?

Answer 1

Should be assessed as least after 1 year and subsequently required

Question 2

Name some findings that indicate your RCT is having a favourable outcome according to ESE guidelines

Answer 2

1. Absence of pain, swelling and her symptoms
2. No sinus tract
3. No loss of function
4. Radiological evidence of a notable periodotbnl ligament space around the root

Question 3

Give some features that may suggest your RCT has an uncertain outcome according to ESE guidelines

Answer 3

If a radiograph recall shows that the lesion has remained the same size of has only diminished in size
If after 4 years the lesion hasn’t vanished then the RCT is a failure

Question 4

According to Friedmans Toronto study when is a RCT successful?

Answer 4

WHEN:

1. The tooth is functional
2. Tooth is asymptomatic
3. Theres no outward sign of infection (swelling or sinus)
4. The lesion is reducing in size

Question 5

What is the alternative to re root canal treatment?

Answer 5

Implants

Question 6

What is failure sometimes called?

Answer 6

Post treatment disease

Question 7

HOW can RCT fail

Answer 7

1. Persistence of disease (wasn’t removed successfully)

2. Emergent disease (new disease that comes along after treatment)

Question 8

Name the 4 factors that can affect if a RCT will be a success or failure

Answer 8

1. Presence/ absence of a lesion (higher if no lesion)
2. Filling extending to within 2mm of radiographic apex (but no extrusion)
3. Well condensed root filling with no voids
4. Good quality coronal restoration (crown)

Question 9

What is the fracture rate for teeth tat have been UNCROWNED following RC?

Answer 9

They have a6 times higher fracture rate

Question 10

Give some other factors that affect the success and failure of RCT

Answer 10

Success ate decreases with :
1. Presence of a sinus 
2, Increased lesion size
3. Absence of a flare up
4. Perforation 
5. If you don't achieve patency
6. If you don't do your penultimate rinse with EDTA 
7. Mixing CHX and NaOCl as irrigants 
8. Missed canals
9. Blockages due t severe curvature
10. Iatrogenic issues

Question 11

How can we reduce the chance of us missing a anal

Answer 11

Always remove the whole pulp chamber so that you can see properly
Have good illumination
Always assume a lower molar has anMB2 na that a lower acne has a lingual canal

Question 12

Give examples of iatrogenic issues that can lead to RCT failure

Answer 12

1. Fracture of instruments

2. Creation of ledges

Question 13

How can we deal with fractured instruments?

Answer 13

1. Bypass them

2. Remove the fractured piece (done by a specialist)