causes of failure of root canal treatment a brief riview

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Powerpoint Templates Page 1 Causes of endodontic failure Dr.Taj Mahmood

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Page 1: causes of failure of Root Canal Treatment a brief riview

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Causes of endodontic

failureDr.Taj Mahmood

Page 2: causes of failure of Root Canal Treatment a brief riview

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INDICATIONS

• Failure of root canal treatment is indicated in following conditions

a)Post treatment persistent lesionb)An increase in size of pre-existing

lesionc)Pain, swelling and loss of functiond)Sinus tracte)Signs of root resorption and

hypercementosis

Page 3: causes of failure of Root Canal Treatment a brief riview

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CAUSES OF FAILURE OF ENDODONTICS

• EXTRA RADICULAR

• INTRA RADICULAR

Page 4: causes of failure of Root Canal Treatment a brief riview

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EXTRA RADICULAR FACTORS

1.Microbial causeAbcess periapical periodontitisOverinstrumentationInfected periapical pocket cyst

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EXTRA RADICULAR FACTORS

2.Non microbial causesForeign bodies

Gutta perchaTemporary filling materialBroken instrumentSealersCotton fibrils

Treatment ; surgical removal of irritant

Cholestrol crystalsTrue cystScar tissue healing

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INTRARADICULAR FACTORS

They may be1. Preoperative2. Operative3. Post operative

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• PREOPERATIVEMisdiagnosis

lack of informationPoor case selection

Un-negotiable canal, resorption, unrestorable tooth, secondarily

periodontal involvementocclusal trauma apical abscess or cyst

Poor prognosisavulsed tooth, unsuccessful

treatment of endo-perio lesion

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• OPERATIVE FACTORS1.Failure to obtain biologic objective

a)improper removal of irritantb)debris pushed beyond the apical foramen

2.Failure to obtain mechanical objectivesa)improper access cavity preparationb)mishaps during canal preparation

short or excess preparation ledgeperforationtransportationmissed canalszipping, elbow formation apical blockage separated instrument

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OPERATIVE FACTORS

c)improper obturationunderobturation or

overobturation3.other causes

irrigant related mishapstissue emphysema

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POSTOPERATIVE FACTORS

• Post operative TraumaFractureSuper imposed non-endodontic lesionPoorly designd final restoration

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Ledge formation

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TREATMENT OPTIONS

• Best is prevention in each and every step of root canal preparation

• Proper diagnosis and treatment planning• Predecide the curving of canals and the

number of root canals• Adequate access cavity and avoid

perforation and too much destruction of structure of tooth

• Proper control of instruments and avoid excessive force

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TREATMENT OPTIONS

• Work in a proper sequence while filing

• Avoid in exerting too much force• Go to surgical removal of lesion and

irritant if necessary or medicate the patient

• Always be relax and comfortable to handle the complication

• If very poor prognosis is indicated then go for extraction