Endodontic Failure Flashcards
What should be assessed after a year of RCT?
- Absence of pain, swelling and other symptoms
- No sinus tract
- No loss of function
- Radiological evidence of a normal PDL
What is an uncertain outcome?
if radiographic changes remain the same size or has only diminished in size.
if lesion persists after 4 years, the RCT is usually considered to be associated with post treatment disease
When does RCT have an unfavourable outcome?
- the tooth is associated with signs and symptoms of infection
- a radiologically visible lesion has appeared subsequent to treatment or a pre-existing lesion has increased in size
- a lesion has remained the same size or has only diminished in size during the 4 year assessment period
- signs of continuing root resorption
What can be left after treatment that is not a sign of persisting apical periodontitis?
a locally visible irregularly mineralised area due to scar tissue formation
What is a pre-op factor that affects success?
presence or absence of lesion
What are operative factors contributing to success?
- Filling extending to within 2mm of radiographic apex (subtract one) but not extruded
- Well condensed root filling with no voids
- Good quality coronal restoration
What are technical complications leading to biological failure?
- Coronal leakage
- Difficult to establish causality
- Good coronal restoration coupled with good quality RCT
What additional factors contribute to success?
- presence of sinus
- lesion size
- no perforation
- getting patency
- penultimate rinse with EDTA (reRCT)
- avoiding mixing CHX and NaOCL
- absence of a flare up
What is a failed biological objective that contribute to success?
- missed canals
Law of Symmetry I
except for maxillary molars, the orifices of the canals are equidistant from a line drawn in a mesial-distal direction through the pulp-chamber floor
Law of Symmetry II
except for the maxillary molars, the orifices of the canals lie on a line perpendicular to a line drawn in a mesial-distal direction across the centre of the floor of the pulp chamber
Law of colour change
the colour of the pulp chamber floor is always darker than the walls
Law of Orifice location 1
the orifices of the root canals are always located at the junction of the walls and the floor
Law of Orifice location 2
the orifices of the root canals are always located at the angles in the floor-wall junction
Law of Orifice location 3
the orifices of the root canals are located at the terminus of the root developmental fusion lines
