Root Canal Treatment Part III

Top 10 Common Reasons For Why Root Canal Procedure Fail

Reason #4: Root canal procedure – stripping of your tooth. Or worst, perforating your tooth

Root Canal Treatment - Root Perforation

The hidden truth is that there is always a chance a root canal procedure failure will occur due to an accident by the dentist during the treatment process. This accident is a procedural error that may cause the loss of your tooth.

Stripping of the root may occur from files that do not follow the shape of a bent canal and you end up with the side of the root canal torn. Once torn, it is very difficult to seal because the stripped area is adjacent to the bone.

Perforations are a disaster. This occurs when your dentist drills through the tooth and beyond the base of the root canal system usually on the floor of the tooth. Perforations can also occur when files lose track and end outside the side of a tooth. This leads to an opening in the base of the tooth which is very difficult to repair. There are methods and materials such as MTA that can fix this. Unfortunately, we as dentists must prevent procedural errors such as perforations and stripping.

Reason #3: Blockage of your root canal

Root Canal Treatment - Blockage

If the root is calcified and therefore your dentist cannot reach the end of the root, you may have a failure occur if there is existing disease at the end of that root.

These blockages can be natural which we term “calcification” or procedure induced. If calcified, there is a good chance you may still keep your tooth. Calcified root canals are like Mother Nature’s way of doing its own root canal. If the dentist gets blocked out by creating a ledge or block accidentally, you also would have the same problem.

Reason #2: Your tooth was already cracked but we didn’t know

Root Canal Treatment - Cracked Tooth


If we immediately see a crack or craze line during the beginning of the root canal procedure, you will be informed that your tooth can’t be saved. Sometimes, we can only detect by opening your tooth and use a mini camera to show you the fracture. However, sometimes we can’t see the craze at all. In fact it is reported in the literature that cracks do exist invisible to the dentist and if bacteria infiltrates the root of your tooth through a miniature, undetected crack, a re-infection situation will result. It is difficult to seal a crack.

You may have spent time and money on your root canal procedure, post and crown and a short while later, realize something is still wrong with your tooth. Or you may have no symptoms at all and the problem (we call lesion) is then detected on a routine x-ray. This is a common reason why root canal teeth can still fail even when the work looks so beautiful on a completed X-ray.

Reason #1: Unfortunately your root canal anatomy is complex

Root Canal Procedure - Canal Anatomy


The reason your root canal procedure failed may be due to a very complex anatomy of the internal system of the tooth. You could have an odd extra system of canals situated near the bottom of the pulp system of your tooth, making accessibility extremely challenging or impossible for your dentist to clean out. Or you may have hidden accessory canals or canals that bifurcate or trifurcate that even when the most high tech dental instruments and devices cannot clean out.

Back teeth have more roots and canals than front teeth, front teeth having single roots and canals and offer easier access and less complex anatomy. The third molar teeth in particular have the most complex root anatomies.


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