Case Selection and Recall Procedures

Question 1

• The single most important
factor affecting RCT
success

Answer 1

Case Selection:

Question 2

⦿To avoid great risk or serious error, you must examine

and fully understand what 4 things?

Answer 2

⦿ the patient
⦿the complexities of the root canal system
⦿the specialized techniques required and
⦿have the appropriate training, instrumentation &
equipment

Question 3

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 ______

Answer 3

REFER!!!

Question 4

The ____ 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.

Answer 4

AAE

Question 5

All retreatment endo cases are ____ risk

Answer 5

High risk

Question 6

Category ______:
Cases only: Undergraduates
– No 2nd or 3rd Molars
– No Molars until 2-3 successful anteriors done
– Nothing through a crown
– Approved by endo faculty for all undergrad

Answer 6

Category 1

Question 7

Category ______:

Cases: Endo Honors/Advanced Endo

Answer 7

Category 2

Question 8

Category ______:Cases: Advanced Endo only

Answer 8

Category 3

Question 9

Procedural Incidents:
–Instrument Separation
–Most or All Perforations
–Can’t find all canals
•Surgery Cases
•Re-treatment Cases
•Insoluble Paste RCT

Answer 9

Refer

Question 10

Why do you refer open apex cases?

Answer 10

GP can’t be seen at apex when they are open

Question 11

The BEST TIME to refer is:
• _____ a problem occurs and
• _____ your Liability is incurred and
• _____ your Credibility is Compromised

Answer 11

BEFORE

Question 12

At what time intervals should the patient be recalled?

Answer 12

6, 12, 24 months

Question 13

______ if patient reports adverse S/S
•Infection, pain or continued sensitivity
•Draining Sinus Tract

Answer 13

Recall immediately

Question 14

2 Diagnostic P/A films
•Normal PDL width
•PARL eliminated
•Normal lamina dura
•Normal to fine-meshed osseous trabeculae
•No resorption
•CBCT ?

Answer 14

Radiographic Recall Procedures

Question 15

\_\_\_\_ recall checklist
•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 *
•  Histologic ?

Answer 15

Clinical recall checklist

Question 16

\_\_\_\_\_ outcome
Can reported symptoms be demonstrated 
clinically?
•  Is issue non-odontogenic?
• Inadequate endodontic treatment?
•  Leaking Coronal Restoration?
• Trauma/Fracture
• Unknown

Answer 16

Diseased outcome

Question 17

What degree of Success should be 
expected/communicated?
• Scores of studies over decades
• Reasonable to say well 0ver 
\_\_\_ % success rate
– Assuming intelligent CASE 
SELECTION
– Assuming competent & careful 
technic

Answer 17

90%

Question 18

– Patient must UNDERSTAND (simple language)
• The current condition and all reasonable options
• The Sequelae of no treatment
• Risks v. Benefits of TX options (>90%)
• Possible procedural complications of RCT
– Separated Instrument & Perforation
– Fracture of root or tooth (need for Crown)
– Other unforeseen complications
– Approximate expectation of success (Prognosis)
• The approximate cost of RCT & all related services
(crown)

Answer 18

Informed consent

Question 19

AGD: Guidelines for \_\_\_\_\_
• Name & contact info for the patient
• Appointment time 
• Reason for the referral
• General background which may affect the case
• Medical & dental information 
– Medical consultations & specific problems
– Previous contributory dental history
– Radiographs !
!70
2 Way Communication
Endodontist should call GD office at completion 
of RCT to schedule Restoration

Answer 19

Referral