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Incidents and accidents influence the outcome of root canal treatment, irrespective of the operative techniques used. The unjustified removal of dental hard tissues may promote structural failure of the root canal treated tooth or recontamination of the intra-canal space. Iatrogenic errors, particularly those associated with the loss of working length due to blockages, can impede adequate cleaning, shaping and filling of the root canals. This can influence the treatment of apical periodontitis as well as tooth retention. This case series discusses common incidents and accidents that can occur during root canal treatment, as well as their possible management.
CPD/Clinical Relevance: Operators should be aware of the possible intra-operative complications during root canal treatment and factors to prevent their occurrence.
Article
Root canal treatment encompasses the management of intra-canal contents, including dental pulp (vital and/or necrotic) and, when present, contamination in the form of biofilms on the root canal wall. An inert material is subsequently placed into the root canals. Technical factors that are associated with improved treatment outcomes during the management of primary apical periodontitis include root fillings without voids and the filling extending to within 2 mm of the radiographic apex of the root.1 The apical extent of the root filling is also a significant factor associated with higher success rates in re-treatment cases.2Figure 1 illustrates technically adequate and inadequate root canal fillings. The absence of peri-apical pathosis prior to treatment, and the provision of a suitable definitive restoration after treatment have a positive effect on root canal treatment outcomes.1,2 Conversely, intra-operative factors, such as perforations and other technical errors, have a negative effect on treatment outcomes.
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