Root Canal Treatment Part I

Top 10 Common Reasons For Why Root Canal Treatment Fail

If you are one of millions of people who will need root canal treatment, you might want to know about some of the risks and troubles that may be accompanied with this procedure. Of the countless number of teeth root treated around the world every year, a portion of them will end up needing an extraction. The root canal system varies in teeth and can be very complicated. Techniques can vary to perform an exceptional root treatment, and in this article, you’ll discover that there are many factors that can lead to failure. The literature states that from 2.5 to 5% of root canal treatment performed, fail! Every dentist should be aware of the issues and inform patients of the risks that may lead to a less than ideal result.

Reason #10: Broken instruments in the canal

Root Canal Treatment - Broken File

Dentists may use more than thirty fine and delicate instruments when performing a root canal. Accidentally breaking an instrument such as a file used to shape and clean the area inside the canal is one complication involving root canal procedures. This can happen in tight root canal systems and when rotary instruments are used. Unfortunately it can lead to failure of your treatment.

If the breakage occurs during the shaping process and after the root canal is cleaned effectively, then it’s still possible to fill and seal the tooth without removing the file remnant with a good overall chance of success. If in fact the root canal was not cleaned yet when the file broke, then the goal is to have that remnant part removed. The unclean part of the canal needs to re-entry and cleaning! If your dentist is unable to retrieve it, you must have a special surgical procedure called an apicoectomy, which is a surgical procedure to fill the root from the root end to remedy the situation. The literature cites that broken instruments in uncleaned canals may lead to failure.

By the way…is it abnormal for files or other instruments break?
It may happen due to abnormally tight or curved canals in the tooth roots. This should be informed to you prior to beginning the procedure. These accidents do happen but there are preventative techniques to lessen the risk. These include the use of specialized shaping instruments to decrease the bending angle of files. Also, there are high grade quality nickel titanium rotary files that are more resistant to breakage. Finally, a major reason for breakage is reusing old files over and over again. This overuse of files can be intentionally done or without knowing. Files should be monitored for wear and thrown away regularly in a very well managed inventory and check systems within the dental clinic.

Reason #9: Insufficient disinfection and debridement of the root canal

Root Canal Treatment - Cleaning File

The goal of root canal treatment is to clean out the dead or partially dead tissue, destroy all bacteria and sterilize the root canal. If your dentist leaves tissue behind, or worse, introduces more bacteria to contaminate your canals, you might get a root canal failure. Luckily, in dentistry there are ways to virtually sterilize the canal. There are three basic procedure step. The first important way is the use of a rubber dam to prevent bacterial invasion.

The rubber dam has been hailed by dentists as the game changer in root canal therapy. Without it, saliva can easily seep its way into the root canal system. If you happen to have a root canal and close your mouth one time without a rubber dam on, you might introduce millions of bacteria into your root canal.

Root Canal Treatment - Rubber Dam

The next procedure step is choosing effective and safe chemicals like bleach, ETDA (a chelation cream) and peroxide to disinfect the internal canal system.

These variety of cleaning materials and solutions to irrigate and wash out the dead contents of your tooth. The goal is consistent cleaning throughout the entire canal down to the terminal end of the root.


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