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Complications of Root Canal Treatment

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Root canal complications refer to undesirable and unintended occurrences that may take place during or after a root canal treatment.

Here we will discuss the specific complications encountered with root canal treatment. General treatment complications, such as nausea or vertigo after local anesthesia, are not mentioned.

The most frequent complication occurs when all the canals present in a tooth are not filled; as can be seen in this animation, the tooth has 4 canals, of which only 3 are filled. In addition, canals are frequently filled incompletely; i.e., the filling does not extend to the root apex. The reasons for incomplete fillings are manifold, some of which include severely curved canals; instrument breakage in the canal; and inexperienced practitioners. The risks of poorly-filled teeth include bone infection and/or cyst formation – so called radicular cyst – even after several years

The abovementioned instrument breakage is also a common complication that can be usually avoided if the instruments are replaced on a regular basis.
Other complications include root/crown perforation. This complication necessitates in the majority of cases tooth extraction.

Overfilling the canal is another complication; it is particularly unpleasant if the tooth border on the maxillary sinus or the mandibular nerve canal because this can cause sinusitis and mandibular nerve inflammation. Excess material located in the mandibular nerve or in the maxillary sinus should be removed even if there is no pain. The animation shows how, during a root canal treatment, filling material is unintentionally pressed into the mandibular nerve canal in the lower jaw. If the excess material is located just in the jawbone, it does not always have to be removed; it should be done if the patient experiences pain and/or if the bone gets inflamed. This can be checked through X-ray images taken semi-annually.

Dark discolorations of the tooth after a root canal treatment are indicative of blood and bacteria contamination during the treatment. Normally, the canal should be clean and free of blood and bacteria. If this is not the case, bacteria will break down the blood, and the iron present in hemoglobin will darken the tooth. All these complications can be avoided if a rubber dam, optical magnification, and clean and well-maintained instruments are used.

An X-ray image is used for simple quality control of a root canal treatment. Here are two dental X-rays, one of a poorly-filled tooth – on the right – and one of a well-filled tooth – on the left. On the left, the canals are homogenously tight, conical, and filled all the way down to the root tip, the white line in the X-ray.

For an experienced specialist – so called Endodontic Specialist, a root canal treatment is a simple and reasonable therapy for long-term maintenance of teeth. If the root canal treatment is executed well, the tooth may render good services for decades, if not for the entire life. Video about Root Canal Treatment Complications.

Complications of Root Canal Treatment