Complications of
endodontic treatment
Local
Regional
Systemic
Plug of
dentin chips
Ledging
Transportation of the root canal
Via falsa
Zipping a elbow
Local complications
Reasons
Insufficient irrigation and
recapitulation
Loss of the working length
Plug
Solution
Repeated careful
instrumentation
with a thin
instrument
Irrigation is not
effective in this
case!!!
Reasons
The instrument is not bended in advance!
No control of the WL
=
No recapitulationLoss of the WL
Ledging
Solution
The instrument must be
bended in advance
Careful but complete rotation
Finishing with the fine filing
No NiTi!!!
Ledging
Zipping a Elbow
The instrument is not bended in advance!
Rotation in curved canals
Stripping
Reasons
Bad orientation in morphology – no diagnostic xInstruments
are nod bended
Rotary NiTi with a big taper
Dangereous zones
Mandibular molars – mesial roots
Premolars, esp. maxillar
Mandibular incisors
Oblast isthmu
Stripping
Důkladný přehled!
Šetřit oblast isthmu!
Ruční preparace!
Menší kónus NiTi !
Stripping
Bend the instrument and eventually blunt it !
Insufficient
coronal flaring
Old root canal
instrument
Aggresive force
Incorrect
movement of the
root canal
instrument
Fracture of the root canal instrument
Reasons
Solution
Enlargement of the
root canal till the
instrument
Ultrasound tips
Rotating root canal
instrument – caution!
Bypass
Leaving in
Surgical treatment
Bypass
Fractured instrument
Via falsa - Perforation
◼ Perforation of the bottom of the pulp chamber
or the coronal part of the root canal
◼ Perforation in the middle part of the root canal
◼ Apical perforation
MTA composition
◼ Dicalcium silicate
◼ Trikalcium silicate
◼ Trikalcium aluminate
◼ Tetrakalcium aluminate
◼ Cuprum sulphate
◼ Bismuthum trioxide
= Portland cement
MTA
◼ Good sealing ability
◼ Promotion of healing
Via falsa - treatment
◼ No bleeding
◼ Desinfection
◼ MTA – moisture (wet cotton pellet)
◼ Filling
Via falsa
◼ Apical perforation
◼ Plug of MTA, root canal filing
MTA
◼ Umožňuje hojení – dobrý okrajový uzávěr !
Zabraňuje přístupu mikroorganismům,
umožňuje hojení dřeně a periodoncia tvrdou
tkání.
Zdroj: Manuál firmy Maillefer
Regional
complications
Fistula
Systemic
complications
Systemic complications
➢Periostitis
➢Inflammation of soft tissues (face, neck)
➢Gulp of the instrument (X ray, remnant diet,
information)
➢Aspiration of the instrument - cough
Caution!
Always find the lost instrument !!!!!!
Safety in endodontics
◼ Rubber dam
◼ Glasses
◼ Careful instrumentation, irrigation, filling (WL,
recapitulation)