Endodontics – stay prepared
Featured Products Promotional FeaturesPosted by: Dental Design 3rd November 2022
Modern dentistry has revolutionised how all dental treatments are delivered, including endodontic procedures.
Nowadays, endodontic care can be performed swiftly and relatively pain-free, protecting the patient’s natural dentition and facilitating its longevity. This is ideal, as the profession has switched focus to saving the tooth first and foremost, before replacing it is considered.
However, due to the nature of the area, dental professionals are still faced with a variety of possible complications when attempting to save a tooth. In light of this, it is essential to make wise investments in solutions that can facilitate a successful and streamlined procedure, as well as minimising the potential for complications.
The root cause
Success rates for endodontic treatment are high, which is encouraging and suggests that more patients are retaining their natural teeth for longer. But, as with most dental treatments, there is still the potential for complications. Endodontic care is incredibly technique sensitive, and the procedures are risky due to the elusive nature of the root canals. Claims made by endodontic patients are considered difficult to defend successfully,[i] and complications can be highly unpleasant for the patient. A treatment can be unsuccessful for many reasons, including missed canals, persistent infection, fractured instruments and iatrogenic injuries.i However, being as well prepared as possible is the key to circumventing these issues, including careful treatment planning, a strong skillset and high-quality equipment.
Common complications and their prevalence
Untreated or missed canals are considered to be a common occurrence during endodontic treatment. Indeed, one study found that out of 1100 endodontically failing teeth, 42% were the result of missed canals.[ii] The bacteria harboured in these canals can trigger persistent inflammation and potential infection, with researchers highlighting that missed canals have a significant impact on the treatment prognosis.[iii] It has been postulated that when there is a higher volume of root canals, the probability of a missed canal is greater.[iv] It is unsurprising, then, that the anterior teeth are considered to be especially at risk, due to their challenging position and the potential for multiple roots and canals.ii Severely curved roots are another major challenge for dental professionals,[v] and conventional methods of treating them could result in further complications, such as blockages and instrument fractures. In these situations, the dental professional must ascertain an appropriate mode of action, including whether to refer the case to a specialist endodontist.
The secret weapon in endodontics?
Prior to treatment, the planning stages of an endodontic procedure (or any dental treatment) are vital to ensure a successful and safe outcome. In recent years, innumerable improvements have been made to the various techniques, tools and equipment within the field of endodontics. This has allowed dental professionals to enhance how they deliver patient care, reducing the occurrence and impact of certain complications.
One such modality is cone beam computed tomography (CBCT), which has revolutionised how dental professionals are able to perform and plan for treatment. In cases where the benefits of using a CBCT outweigh the risks, these systems are highly efficient and effective. Researchers have noted the CBCT scanner’s efficacy in measuring the number of roots, their morphology, the root and accessory canals, in addition to their lengths and angulations.[vi] Moreover, CBCT scanners have a lower dose than the conventional computerised tomography (CT) scanner, producing a high-resolution, 3D scan of the dentomaxillofacial region without such a high risk to the patient, especially in paediatric or geriatric cases.
An investment to last a lifetime
Providing safe treatment, as well as successful and long-lasting outcomes, has always been the goal of every dental professional. Modern dentistry now provides solutions that wholly support this. If a practice offers endodontic treatment, it is important to ensure you have the right tools at hand to remain well-prepared for any potential complication.
CBCT scanners are an investment, and the benefits they provide can completely transform the way that care is delivered. All team members and patients alike will appreciate the difference a CBCT system can make. Clark Dental is proud to offer professionals the exceptionally comprehensive ORTHOPHOS S3D hybrid X-ray unit. This model boasts of the full range of capabilities for both 2D and 3D workflows. The CSL sensor with an autofocus function facilitates clear images, even in anatomically challenging cases. With flexible volume sizes and dose options, dental professionals can appreciate an optimised and consistent workflow.
Endodontic treatment allows patients to enjoy their natural teeth for longer, but due to the complexities of the field, complications can occur. To combat them, dental professionals require reliable, robust and high-quality systems to plan for any situation. The result will be a streamlined, successful procedure and a satisfied patient.
For more information call Clark Dental on 01268 733 146, email info@clarkdental.co.uk or visit www.clarkdental.co.uk
[i] ddujournal.theddu.com. (2015). Pulp fact – looking inside endodontic claims. [online] Available at: https://ddujournal.theddu.com/issue-archive/issue-3/pulp-fact—looking-inside-endodontic-claims [Accessed 10 Aug. 2022].
[ii] Tabassum, S. and Khan, F. (2016). Failure of endodontic treatment: The usual suspects. European Journal of Dentistry, [online] 10(1), p.144. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4784145/ [Accessed 10 Aug. 2022].
[iii] Baruwa, A.O., Martins, J.N.R., Meirinhos, J., Pereira, B., Gouveia, J., Quaresma, S.A., Monroe, A. and Ginjeira, A. (2019). The Influence of Missed Canals on the Prevalence of Periapical Lesions in Endodontically Treated Teeth: A Cross-sectional Study. Journal of Endodontics. [online] Available at: https://pubmed.ncbi.nlm.nih.gov/31733814/ [Accessed 10 Aug. 2022].
[iv] do Carmo, W.D., Verner, F.S., Aguiar, L.M., Visconti, M.A., Ferreira, M.D., Lacerda, M.F.L.S. and Junqueira, R.B. (2020). Missed canals in endodontically treated maxillary molars of a Brazilian subpopulation: prevalence and association with periapical lesion using cone-beam computed tomography. Clinical Oral Investigations, [online] 25(4), pp.2317–2323. Available at: https://pubmed.ncbi.nlm.nih.gov/32875385/ [Accessed 10 Aug. 2022].
[v] Patnana, A. and Chugh, A. (2018). Endodontic management of curved canals with protaper next: A case series. Contemporary Clinical Dentistry, [online] 9(5), p.168. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6006870/ [Accessed 10 Aug. 2022].
[vi] Kumar, M., Shanavas, M., Sidappa, A. and Kiran, M. (2015). Cone beam computed tomography – know its secrets. Journal of international oral health: JIOH, [online] 7(2), pp.64–8. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4377156/ [Accessed 10 Aug. 2022].
