Procedural Errors in Endodontics and its Management
An analysis of etiology, diagnosis, prevention and management of endodontic procedural errors for improved patient care
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Endodontic therapy is highly predictable, yet 5-20% of cases fail due to procedural errors that compromise infection control and sealing. These mishaps arise from anatomical complexities, diagnostic errors, and operator limitations, and are grouped as access, instrumentation or obturation related errors.Access errors include treating the wrong tooth, missed canals, damage to restorations, and perforations. Instrumentation errors such as ledge formation, perforations, instrument separation, canal blockages, and irrigant extrusion hinder effective cleaning and shaping. Obturation errors-overfill...
Endodontic therapy is highly predictable, yet 5-20% of cases fail due to procedural errors that compromise infection control and sealing. These mishaps arise from anatomical complexities, diagnostic errors, and operator limitations, and are grouped as access, instrumentation or obturation related errors.Access errors include treating the wrong tooth, missed canals, damage to restorations, and perforations. Instrumentation errors such as ledge formation, perforations, instrument separation, canal blockages, and irrigant extrusion hinder effective cleaning and shaping. Obturation errors-overfilling, underfilling, and vertical root fractures-compromise the seal and may lead to failure or extraction. Miscellaneous issues like failed anesthesia and tissue emphysema, though less common, pose additional risks.Prevention and early recognition are central to management. Advances such as CBCT, dental operating microscopes, ultrasonic retrieval, and bioactive repair materials enhance diagnosis and prognosis. Success in endodontics ultimately depends on careful technique, modern technology, and continual operator skill refinement.
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