Complications of endodontic treatment
 Local
Regional
Systemic

komplikace komplikace1
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!!!

>

penka okacschudek bajer0604
Ledging


•
•
 Zipping a Elbow
The instrument is not bended in advance!
Rotation in curved canals

•
•
stullerovazip

Stripping
n
Reasons
Bad orientation in morphology – no diagnostic x-ray
Instruments are nod bended
Rotary NiTi with a big taper
Dangereous zones
Mandibular molars – mesial roots
Premolars, esp. maxillar
Mandibular incisors
Oblast isthmu

Stripping
n

Důkladný přehled!
Šetřit oblast isthmu!
Ruční preparace!
Menší  kónus NiTi !

Stripping
klusakovapopl
 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
n Perforation of the bottom of the pulp chamber or the coronal part of the root canal
n
nPerforation in the middle part of the root canal
n
nApical perforation
n

P1010002 P1010002 mtabahno



MTA composition
n Dicalcium silicate
nTrikalcium silicate
nTrikalcium aluminate
nTetrakalcium aluminate
nCuprum sulphate
nBismuthum trioxide
n= Portland cement
n
vachaor vachaorupr

MTA
nGood sealing ability
nPromotion of healing
mta7

mtafurkace mtafurkace1 mtafurkace1



mtaklinika1 mtaklinika2 mtaklinika3



Via falsa - treatment
n No bleeding
nDesinfection
nMTA – moisture (wet cotton pellet)
nFilling
stullerovazip

bocekvych bocek s MTA bocekpopl bocekkontrola1



bocekpochir bocekkorunka bocek uprav



Via falsa
n Apical perforation
n
nPlug of MTA, root canal filing
stullerovazip

MTA
nUmožňuje hojení – dobrý okrajový uzávěr !
nZabraňuje přístupu mikroorganismům,
numožňuje hojení dřeně a periodoncia tvrdou
n tkání.
mta7

mtafurkace mtafurkace1 mtafurkace1
Zdroj: Manuál firmy Maillefer


mtaklinika1 mtaklinika2 mtaklinika3



okacvych1
n
Bez názvu 1 kopie capovova1

Regional complications



n
frankova3 frankova1 frankova2 frankova4 frankovazhoj


IMG_1378
Píštěl


 Systemic complications



Systemic complications
ØPeriostitis
Ø
ØInflammation of soft tissues (face, neck)
Ø
ØGulp of the instrument (X ray, remnant diet, information)- cough
n
ØAspiration of the instrument -emesis
Ø
Ø

n
ciziteleso1 ciziteleso2


 Caution!
n
n
n
nAlways find the loss instrument !!!!!!
n
n
n
n
n
n