endo failure and retreatment Flashcards
(22 cards)
prediction of the outcome of resolution of apical periodontitis
prognosis
end result that follows as a consequence of endodontic treatment
outcome
different criterias used in determining outcome
strinberg’s criteria
bender
friedman and Mor
AAE outcome criteria
published a landmark study
laid the foundation for conduct of future endo outcome
follow up period was 6 years, every 6 months for the first 2 years and yearly thereafter
larz strindberg (1908-1972)
highlights of the study of larz strindberg
established criteria for eval of endo outcome
presented success rates for orthograde endo treatment
related the outcome of endo treatment to the preoperative periapical diagnosis
defined the duration and frequency of follow-up
strindberg criteria
contours and width of the PDL are normal
pdl contours are widened maily around excess root filling
lamina dura is intact
Outcome: success
Clinical: no symptoms
strindberg criteria
unchanged periradicular rarefaction
decrease in periradicular rarefaction
appearance of new rarefaction or an increase in the size of initial rarefaction
discontinous or poorly defined lamina dura
outcome: failure
Clinical: symptoms present
strindberg criteria
ambiguous or technically unsatisfactory radiograph which coulc interpreted with certainty
periradicular rarefaction less than 1mm and disrupted lamina dura
tooth was extracted prior to blabla blab endo outcomer
outcome: uncertain
clinical: –
AAE outcome criteria
I. healed
II. nonhealed
III healing
IV functional
AAE outcome criteria
functional. asymptomatic teeth with no or minman radiographic periradicular pathosis
healed
AAE outcome criteria
nonfunctional, symptomatic teeth with or without radiographic periradicular pathosis
nonhealed
AAE outcome criteria
teeth with periradicular pathosis, which are asymptomatic and functional, or teeth with or withour radiorgaphic periradicular pathosis, which are symptomatic but those intended function is not altered
healing
AAE outcome criteria
a treated tooth or root that is serving its intended purpose in the dentition
questionable prognosis
functional
recall protocol of AAE
1yr if
- unchanged or has increase in size after 1yr
- unlikely to ever resolve
- deemed unsuccessful
when?
6months
- present but smaller in size
- might heal but additional recall is needed
4 types of posttreatment disease
- persistent or reintroduced intraradicular microorganisms
- extra radicular infection
- foreign body reaction
- true cyst
how to diagnose posttreatment disease
colleting subjective information, developing objective findings, and using these to arrive to a diagnosis and plan of treatment
treatment of choice it it were determined that the procedure is feasible because the tooth is restorable, periodontally sound and the root canal system are accessible from a nonsurgical approach
retreatment
high efficacy in dissolving GP and sealers
antimicrobial high toxicity if inhaled or extruded beyond confines of the canal
chloroform
low efficacy in dissolving GP and sealers
antimicrobial activity unknown
low toxicity if inhaled or extruded beyond confines of the canal
eucalyptol
low efficacy in dissolving GP
high antimicrobial activity
high toxicity if inhaled or extruded beyond confines of the canal
rectified oil of turpentine
high efficacy in dissolving GP and sealers
antimicrobial activity unknown
nil toxicity if inhaled or extruded beyond confines of the canal
orange oil
