Endodontic Failure: Causes and Symptoms

What percentage of endodontic cases may experience persistent or recurrent symptoms?

When do many endodontic failures occur following the initial root canal treatment?

What is an important part of endodontic treatment traditionally?

What does periapical surgery involve?

What are the indications for periapical surgery?

What might be a risk of attempting root canal re-treatment through a crown on a mandibular incisor?

When may root resection and root end filling be considered instead of root canal re-treatment?

What is a common requirement for surgery in the case of failed treatment on a tooth restored with a post and core?

When might surgical removal of an apical segment be necessary after traumatic root fracture?

What can be done surgically if canals are blocked by objects such as broken instruments and evidence of apical pathosis is found?

Endodontic Cases and Outcomes

Approximately 5-20% of endodontic cases may experience persistent or recurrent symptoms after treatment.
Many endodontic failures occur within the first year following initial root canal treatment.

Key Components and Procedures

An important part of endodontic treatment traditionally involves achieving a proper seal of the root canal system to prevent bacterial invasion.
Periapical surgery involves the surgical removal of the tip of the tooth's root along with any surrounding infected tissue.

Indications for Surgery

Indications for periapical surgery include persistent infection, failure of conventional endodontic therapy, or the presence of anatomical complexities that complicate retreatment.
Surgical removal of a fractured apical segment may be necessary when a traumatic root fracture prevents proper healing and resolution of infection.

Risks and Alternatives

Attempting root canal re-treatment through a crown on a mandibular incisor may risk compromising the integrity of the crown and further damaging the tooth structure.
Root resection and root end filling may be considered instead of root canal re-treatment when significant structural loss or failure of traditional methods is evident.

Surgical Requirements

A common requirement for surgery in cases of failed treatment on a tooth restored with a post and core is that the post should be removed to allow better access for treatment.
If canals are blocked by objects such as broken instruments and there is evidence of apical pathosis, surgical intervention may be necessary to remove the blocking object and treat the resulting infection.

Test your knowledge about the causes and symptoms of endodontic failure with this quiz. Explore the reasons for persistent or recurrent symptoms following conventional endodontic treatment, and learn about recognizing indications of problems with the initial procedure.