success and failure endodontics Flashcards
when should we measure the RCT
1 year after the treatment and subsequently as followed
what do we look for after a RCT
absence of pain, swelling, other symptoms no sinus tract, no loss of function and radiological evidence of a normal PDL around the root
how is success measured
no pain no loss of function no swelling no other symptoms no sinus tract evidence of normal PDL space around the root
when is it classed as an uncertain outcome
if the lesion has stayed the same size or diminished slightly
how long do we need to assess a lesion for
a minimum period of 4 years
what happens if the lesion persists after 4 years
considered to be associated with post treatment
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
no other symptoms
no sinus tract
evidence of normal PDL space around the root
the issue with this is the four year period which is not practical
what is the loose criteria
by the toronto studies- more practical and sensible approach. the tooth should be functional,apin free and no swelling/sinus tract and the lesion decreases in size
what is the survival criteria
easy to be big studies and as long as the tooth is in the mouth its successful: doesn’t take into account pts 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
what can increase the failure rate
presence of sinus
increased lesion size
missed canals
iatrogenic damage
what can increase the success rate
absence of flare up
no perforation
getting latency
why do we not mix NaOlc and CHX
AS it forms a precipitate called para chloroalanine and this can block canals and is toxic and carcinogenic
why do we do a penultimate rise with EDTA
EDTA removes smear layer and organic debris
