Success/ failure in Endodontics

Question 1

when should we assess a root canal treatment we have carried out

Answer 1

Should be assessed at least after 1 year subsequently required

Question 2

Name some findings that indicate your RCT is having a favourable outcome according to ESE guidelines

Answer 2

1. Absence of pain, swelling and symptoms
2. No sinus tract
3. No loss of function
4. Radiological evidence of notable periodontal ligament space around the root

Question 3

Give some features that may suggest that your RCT has an uncertain outcome according to ESE guidelines

Answer 3

if a radiograph recall shows that the lesion has remained the same size or has diminished very slightly in size
if after 4 years the lesion hasn’t disappeared the RCT is a failure

Question 4

According to Friedmans Toronto study when is a RCT successful?

Answer 4

WHEN:
1. The tooth is functional
2. Tooth is asymptomatic
3. Theres no outward sign of infection (swelling or sinus)
4. The lesion is reducing in size

Question 5

How can RCT fail

Answer 5

1. Persistence of disease (wasn’t removed successfully)
2. Emergent disease (new disease that comes after treatment)

Question 6

Name the 4 factors that can affect if a RCT will be successful or failure

Answer 6

1. Presence/ absence of a lesion
2. Filling extending to within 2mm of radiographic apex
3. Well condense root fillings with no voids
4. Good quality coronal restoration

Question 7

Give some other factors that affect the success and failure of RCT

Answer 7

Success Rate decreases with :
1. Presence of a sinus
2, Increased lesion size
3. Absence of a flare up
4. Perforation
5. If you don’t achieve patency
6. If you don’t do your penultimate rinse with EDTA
7. Mixing CHX and NaOCl as irrigants
8. Missed canals
9. Blockages due t severe curvature
10. Iatrogenic issues

Question 8

How can we reduce the chance of us missing a canal

Answer 8

Always remove the whole pulp chamber so that you can see properly
Good illumination

Question 9

Give examples of iatrogenic issues that can lead to RCT failure

Answer 9

1. Failure of instruments
2. Creation of ledges