Unsatisfactory endodontic treatment is one of the most common malpractice insurance claims. If in doubt, you risk nothing by asking for specialist advice. Your patients will appreciate the concern and effort on their behalf.
Careful evaluation is advised in the following situations:
- Diagnosis: When symptoms are vague, signs inconclusive and radiographic evidence limited, a correct diagnosis can be very difficult.
- Access to the tooth: When patients have limited opening of their mouth getting access to posterior teeth can become very difficult.
- Curved canals: These require particular techniques and instruments. Without them, ledging, blocking, stripping or perforation of the canal is easily done.
- Calcified canals: These can be difficult to locate and are usually found in older patients, heavily restored teeth or one that has suffered trauma.
- Surgical endodontics: For cases that have to be treated by endodontic surgery the latest microsurgical techniques are used, however many cases that used to be treated surgically can now be dealt with by non-surgical root canal re-treatment. The results are more predictable and successful than ever before. The need for endodontic surgery has not been eliminated but modern techniques allow it to be drastically reduced.
- Re–treatment cases: Previous endodontic treatment that has failed is best dealt with by the specialist. This includes dealing with calcification, broken instruments, perforations, the removal of posts and existing root filling materials (pastes, gutta percha and silver points as well as fractured instruments).
- Elective endodontics: There are situations where the pulp may have to be sacrificed for restorative reasons. Elective re-treatment of a previously root canal treated tooth may be indicated even though the tooth is symptomless and especially recommended where a new crown or bridgework is planned.