Post endodontic treatment_disease
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Post endodontic treatment_disease

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    Post endodontic treatment_disease Post endodontic treatment_disease Presentation Transcript

    • Post Endodontic Treatment Disease Michael Gossack
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    • Post Endodontic Treatment Disease vs Endodontic Failure
    • Topics of Discussion
      • Diagnosis
      • Etiology
      • Treatment Options
      • Clinical cases
    • Diagnosis
      • Patient Complaint ( if any)
      • Clinical Examination
      • Radiographic Examination
      • Elimination of Other Possible Etiologies
    • Patient Complaint
      • Can patient localize symptoms to a particular tooth
      • Temperature sensitivity
      • Previous swelling or drainage
      • Sensitivity to pressure chewing
    • Clinical Examination
      • Percussion sensitivity
      • Palpation sensitivity
      • Swelling
      • Sinus tract
      • Periodontal pocketing
      • Fracture lines
    • Radiographic Examination
      • Evaluation of previous endodontic treatment
      • Periapical radiolucent lesion
      • Bone loss on lateral aspect of root
      • Tracing of sinus tract
    • Eliminate Other Etiologies
      • Pulpitis from another tooth
      • Healing in progress
      • Sinusitis
      • Perio
      • TMJ
      • Neuralgias
    • Etiology
      • Inadequate prior root canal therapy
      • Fractures
      • Coronal leakage
      • Complex root canal anatomy
    • Inadequate Prior Treatment
      • Canal treated short of apex
      • Poorly cleaned and shaped canal
      • Poorly obturated canal
      • Missed canal-MB root Max Molars most common - D roots Mand Molars, Mand Incisors, Max Premolars
      • Iatrogenic Errors- perforations, separated instruments, ledged canals, post perforations, transported canals
    • Treatment Options
      • Retreatment with possible disassembly
      • Periapical Surgical Treatment
      • Extraction
      • (Intentional Replantation)
    • Treatment Considerations
      • Patient’s motivation to save tooth or pursue best long term outcome
      • Periodontal Status of Tooth
      • Restorability of Tooth
      • Strategic Value of Tooth
      • Costs Involved
      • Time Constraints
      • Previous Treatments Performed
      • Clinician’s Experience, Skill, and Armamentarium
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