Management of Endodontics failure Flashcards
Are PA lesions always present on radiographs?
No, which creates confusion when diagnosing
What are two common reasons for failure of endo treatment?
Generally, the treatment has not veen done correctly. Might look pretty, doesn’t mean it has been done right.
Missed canals are very common
What are the stages of treatment planning for failed endo cases?
Decision making – diagnosis
Consider options – non-surgicalretreatment, retreatment, extraction withor without prosthodontic replacement ormonitor
Write in your notes that you have discussed this
What are the re-treatment techniques?
Need to find all the canals – know the anatomy
Ensure the roof of the pulp chamber isentirely removed so you can see all ofthe pulpal floor
What is a restorability assessment?
First part of endodontic procedure should always be a restorability assessment
Cause of much endodontic ‘failure’ is restorative
This can often be diagnosed at the outset
What are the steps when re-treating?
Removal of GP
Best if possible en masse
Braiding technique
Use of reciprocation / rotary
Hand files and solvent
List a few re-treatment techniques?
Use Hedström files
End cutting
Engage into the GP, quarter/half turnand remove
Do not screw into dentine
If can’t engage the GP then soften withsolvent
Important to know what you are trying to remove
How do you finish off the prep after re-treating?
Solvent useful at the end to remove sealer and persistent bits of GP
Once GP removed, undertake chemo-mechanical preparation as with a primary RCT case
What are the risks of forcing re-treatment files or GG drills?
Easy to create ledges or perforations
What can you use to help engagement of files in the GP?
You can use heat