Operator-related aspects in endodontic malpractice claims in Finland

Vehkalahti, Miira M.; Swanljung, Outi

doi:10.1080/00016357.2016.1272000

Cited by 8 publications

(12 citation statements)

References 20 publications

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“…Unfortunately, many dentists seem to leave several details unrecorded. However, the level of documentation has improved in the last years (21), which was also seen as an improvement in documentation of the use of root canal irrigants and medicaments in our study. Still, none of the documents scrutinized gave any information about the method of the application of root canal irrigants and medicaments (ie, syringe or not and, in case of syringe, the type of needle used).…”

Section: Discussionsupporting

confidence: 65%

“…In 2011 to 2016, PIC handled an annual average of 7700 claims, 700 of which were related to dental care, but no detailed information about the types of injuries is given in the PIC official statistics. Previous research reports from Finland have shown that endodontics predominate in dental malpractice claims in the 2000s, reaching up to 200 claims annually (20,21). A recent report from the United States describes a similar increasing trend in dental malpractice cases from 2004 to 2014 (22).…”

Section: Introductionmentioning

confidence: 83%

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Root Canal Irrigants and Medicaments in Endodontic Malpractice Cases: A Nationwide Longitudinal Observation

Swanljung

Vehkalahti

2018

Journal of Endodontics

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Section: Discussionsupporting

confidence: 65%

Section: Introductionmentioning

confidence: 83%

Root Canal Irrigants and Medicaments in Endodontic Malpractice Cases: A Nationwide Longitudinal Observation

Swanljung

Vehkalahti

2018

Journal of Endodontics

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“…We can, however, infer that the perforations were massive or otherwise serious since the majority of the cases resulted in tooth extraction. A further limitation is that these data cannot answer the question about the reasons leading to accidental perforations because the quality of the patient documents varied widely [21], and consequently, descriptions of the incidents or attempts to repair them varied from detailed to minor or none.…”

Section: Discussionmentioning

confidence: 99%

Accidental perforations during root canal treatment: an 8-year nationwide perspective on healthcare malpractice claims

Vehkalahti

Swanljung

2020

Clin Oral Invest

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Objectives To assess occurrence and its variation over time of serious accidental perforations during endodontic treatment and the fate of perforated teeth by tooth type and characteristics of patients and dentists. Materials and methods Data, based on patient documents on healthcare malpractice claims, comprised all endodontic injuries (n = 970) verified by the Patient Insurance Centre in Finland in 2002-2006 and 2011-2013. Two specialists in endodontics scrutinized the documents. Accidental perforations were recorded by location (tooth type, chamber/canals) and dichotomized as avoidable (could have been avoided by following good clinical practice) or unavoidable (normal treatment-related risks). Fate of perforation cases was recorded as treatment discontinued, root canal(s) filled, or tooth extracted. Background information included patients' and dentists' sex and age and the service sector. Statistical evaluation used Chi-square tests. Results Serious accidental perforations comprised 29% of all verified injuries. Most perforations were judged as avoidable: 93% in patients aged below 35 years, 87% when located in the pulp chamber or in molars (84%); 70% of all perforations and 75% of those in molars resulted in tooth extraction. The overall rate of serious accidental perforations was 17.6 cases per 100,000 endodontic patients per year. Conclusions The rate of serious accidental perforations increased over time. The majority was in molars and resulted in tooth extraction. Clinical relevance Accidental perforations comprise almost a third of serious injuries during root canal treatment. However, four of five perforations could be avoided by following good clinical practice. Therefore, training is needed before adopting new working equipment and methods.

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“…Failure to observe these conducts may lead to lawsuits in which the operator can be held liable for material, moral and aesthetic damages, since the expert literature reports that Endodontics is one of the dental specialties frequently cited in prevalence judicial process research in Dentistry (Pinchi et al, 2013;Caputo et al;Zanin et al;Vehkalahti & Swanljung, 2017).…”

Section: Discussionmentioning

confidence: 99%

Extrusion of Endodontic Material to the Maxillary Sinus: Avoidable Intercurrence?

Scartezini¹,

Souza

Mathne

et al. 2019

Int. J. Odontostomat.

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The objective of this study is to discuss and analyze whether extrusion of endodontic material constitutes avoidable intercurrence, discussing the clinical, ethical and legal implications. Patient LSR, 31 years old, female, attended a dental consultation complaining of pain in the second left maxillary premolar (tooth 25). Radiographically, a single root canal and thickening of the periodontal ligament associated with extravasation of 8 mm of gutta percha to the maxillary sinus were observed. The first endodontic session aimed to performing the desobturation, root canal preparation and intracanal medication placement. The root canal obturation was performed in the second session. Was carried out an apical surgery that removed 2 mm from the root apex and also performed the covered with a collagen membrane. A 22 months follow-up revealed a tooth function, absence of painful symptomatology or infection, and radiographically normal periodontal ligament and bone neoformation. The second single-root premolar is the type of premolar with less distance with the floor of the maxillary sinus. In this case, the extrusion of the obturator material occurred due to the superinstrumentation of the root canal associated with the proximity of the root with the membrane of the maxillary sinus. From the ethical and legal point of view, the patient has the right to be informed about any intercurrences that may arise during or after the treatment, and the informed consent form is essencial. This document will allow the patient to make a decision about performing an endodontic treatment in which the risk of an accident or complication is imminent or that treatment failure is already expected. It is important that professionals make appropriate diagnosis and treatment plan for each case, since this conduct may avoid clinical intercurrences. In addition, if the intercurrences occur, the patient should be advised of how to proceed.

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Operator-related aspects in endodontic malpractice claims in Finland

Abstract: Operator-related factors had no impact on endodontic malpractice claims.

Cited by 8 publications

References 20 publications

Root Canal Irrigants and Medicaments in Endodontic Malpractice Cases: A Nationwide Longitudinal Observation

Root Canal Irrigants and Medicaments in Endodontic Malpractice Cases: A Nationwide Longitudinal Observation

Accidental perforations during root canal treatment: an 8-year nationwide perspective on healthcare malpractice claims

Extrusion of Endodontic Material to the Maxillary Sinus: Avoidable Intercurrence?

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