Endodontic outcomes and management of failure Flashcards
When should a root canal be assessed after treatment
At least after 1 year
List 5 findings that indicate a favourable outcome for rct
Absence of pain and swelling
No sinus tract
No loss of function
Radiological evidence of a normal periodontal ligament space around the root
What would indicate an uncertain outcome for a rct
Radiographic evidence of lesion remaining same size or slightly smaller
If an rct has an uncertain outcome, how long should you assess the lesion for
Minimum period of 4 years
If a lesion persists after 4 years of the rct what os it usually considered to be associated with
Post-treatment disease
What are some definitions of the outcome
Strict criteria
Loose criteria
Survival
Failure
What is strict criteria
By Strindberg 1956- no pain
No loss of function
No swelling
Nop other symptoms
No sinus tract
Evidence of normal PDLA space around the root
What’s an issue with strict criteria
the 4 year period isn’t practical
What is the loose criteria
By the Toronto studies
More practical and sensible approach
Tooth should be:
Function
Pain free
No swelling
No sinus tract
The lesion has decreased in size
What is the survival criteria
As long as the tooth is in the mouth its successsfull
What is an issue with the survival criteria
Doesn’t take in to account the patients pain or function of the tooth
what are the four factors identified which affect the success/failure of endodontically treated teeth
presence/absence of the lesion
filling extending to 2mm of the radiographic apex- where we have prepared the canals to
well condensed roots with no voids
not extruding out of the canals
Loist 4 things that can increase the failure rate
presence of sinus
increased lesion size
missed canals
iatrogenic damage
List 3 things that can increase the success rate
absence of flare up
no perforation
getting latency
why do we not mix NaOlc and CHX
It forms a precipitate called para chloroalanine and this can block canals and is toxic and carcinogenic
