Clinical negligence or endodontic mishaps: A surgeons dilemma

Abstract

Complications may occur during and after endodontic treatment, which may be due to negligence of the operator. The surgical treatment of a case presenting pain and persistent pus discharge and swelling due to the extrusion of the root canal filling to the base of the nasal floor between left maxillary lateral and canine teeth is presented in this report. First, carelessness was during root canal treatment that was over obturated and second time during extraction in which overextended gutta-percha remained in the bone, caused the complications like pain, persistent pus discharge, and headache. Clinicians should be aware of the fact that endodontic instruments and filling materials (solid or liquid) can be extended in such a degree that can lead to neurological or sinus complications.

Endodontic Retreatment Failure of Mandibular First Molar and Its Periapical Surgical Management with MTA and Bone Graft—A Case Report

“…Overfilling of the root canal, a common iatrogenic complication of RCT, deteriorates the prognosis of endodontic therapy. 5 MTA is a remarkable root end-filling material. 7 It was introduced to dentistry in 1993 by Torabinejad et al It shows commendable sealing ability and promotes osteoblastic activity.…”

“…It can induce peri-radicular inflammation and/or necrosis of the periodontal ligament, and for this reason, overfilling should be avoided as much as possible because it can lead to failure of root canal therapy in the long run. 5 Endodontic surgery has recently improved, with the rates of success crossing 90%. Apparently, the patient's sex, age, and tooth type, tend to carry no effect on the treatment success.…”

“…4 This response plays a major role in determining the prognosis of the endodontically treated teeth. 5 When such a foreign body or a bacterial colony lies beyond the root apex, it may give rise to a self-sustaining extra-radicular lesion. RCT failure resulting from such lesions is either managed by orthograde root canal retreatment or by apical surgery.…”

N Vitrocomparison of the Accuracy of Two Apex Locators of Different Generations

“…The accuracy of apex locators is very important for the correct working length determination of the root canal, and thus for successful endodontic treatment (1,2). It is generally accepted that the endodontic treatment should be limited within the root canal (3,4). The distance from a coronal reference point to the apical point at which canal preparation and obturation should terminate represents the working length of the root canal (5,6).…”

Frequency, impact, and predictors of persistent pain after root canal treatment

“…While persistent tooth pain following RCT may be related to the presence of endodontic lesions [31], infection [26], incomplete/complete root fracture [5], or surgical complications [30], many cases do not have discernible causes upon follow-up evaluation [21,27]. Therefore, it is plausible to consider predisposing factors that could contribute to the presence of persistent pain, some of which have recently been elucidated for other regions of the body after surgery, such as the presence or level of pre-surgical pain and psychosocial factors [4,6,16,23].…”