Case Selection and Recall Procedures Flashcards
(31 cards)
The single most
important factor affecting
RCT success
Case Selection
To avoid great risk or serious error, you must examine
and fully understand:
(4)
the patient
the complexities of the root canal system
the specialized techniques required and
have the appropriate training, instrumentation &
equipment
Consider:
(2)
⦿The great variety of personality types
⦿Your current patient management skills
Never start RCT on any tooth for which
an excellent
result cannot be reasonably expected . . . in your hands
at that time with that patient.
If not, you must ethically & morally REFER
Standard of Care
In the eyes of the legal community:
*The Standard of Care expected of the General Dentist is exactly
the same as that expected of the Endodontic Specialist.
Case Difficulty Assessment Form
The AAE has developed a form which will help you determine the
difficulty/risk level of each case in question.
Once you determine the difficulty level, you have a reasonable
basis to decide if you should
ACCEPT the case or REFER.
COLUMN CATEGORIES:
(3)
- Minimal Risk
- Moderate Risk
- High Risk
Review each column and each related entry:
- If it is a concern, place –
- Column with most checks
determines
check
Difficulty Level
RETX & Procedural Incidents
are all – Risk Cases
High
AAE Case Difficulty @ UMKC
Category 1 Cases only: Undergraduates
(4)
No 2ndor 3rdMolars
No Molars until 2-3 successful anteriors done
Nothing through a crown
Approved by endo faculty for all undergrad
Category 2 Cases:
Endo Honors/Advanced Endo
Category 3 Cases:
Advanced Endo only
Procedural Incidents:
(3)
–Instrument Separation
–Most or All Perforations
–Can’t find all canals
Routinely Refer
(3)
*Surgery Cases
*Re-treatment Cases
*Insoluble Paste RCT
May refer at ANY TIME Before or during the DX or treatment
The BEST TIME to refer is:
(3)
BEFOREa problem occurs and
BEFOREyour Liability is incurred and
BEFOREyour Credibility is Compromised
Recall immediately if patient reports
adverse S/S
Infection, pain or continued sensitivity
Draining Sinus Tract
Minimum Recall Intervals
6 months to 1 year * “Greatest Improvement”
2 years
4 years
Required Recall of a minimum of — RCT patient Recalls:
May be asked to Recall RCT patients of graduates
2
Purpose of Endodontic Recall:
(4)
Assess status of treated tooth
Determine need for additional treatment
Document Recall Procedures
(or 3 Unsuccessful Documented Attempts)
Assess status of treated tooth
(3)
*Healed/Healing
*Functional
*Diseased
Skipped
Areas of evaluation:
Radiographic
–2 Diagnostic P/A films
(6)
Normal PDL width
PARL eliminated
Normal lamina dura
Normal to fine-meshed osseous trabeculae
No resorption
CBCT ?
Clinical:PERCUSSION (-), PALPATION (-),
NO DRAINING SINUS TRACT (DST)
Skipped
Clinical
(6)
Persistent subjective symptoms
Recurrent sinus tract or swelling
Discomfort to percussion and / or palpation
Evidence of fractured tooth
Excessive mobility or progressive periodontal
breakdown
Inability to function on the tooth *
