Dental Health: Root Canal Failures

Jul 10, 2016 News

By Dr. Neromini Fagu

We have spent the last several weeks talking about root canal therapy and now I give a warning – root canals can fail. As with most procedures there are no guarantees. Even with the best of surgeons and the best of equipment there may be failure of a root canal treated tooth. Also, we all have different immune systems. Sometimes the body’s ability to heal is just not successful. This week we will look at some of the reasons for failure and possible treatment options.
Undetected canals
Sometimes a tooth may have more individual root canals than normal. Even with dental x-rays, these canals may be missed by the dentist.
This is especially so if these unexpected canals are very tiny. If they remain untreated they may become problematic later.
Irregular canals
The anatomy of root canals can vary. Some may have forks or branches. These variations in canals may be very small which make them difficult to detect and access. These irregular canals may have one branch treated properly while the other is not.
Cracked teeth
Sometimes cracks may form within a tooth leaving a space for bacteria to inhabit. However, these cracks are not like root canals that can be accessed so they can’t be treated. Once they become colonized with bacteria an infection may developleading to problems. Also, these cracks are sometimes difficult to identify.
Deterioration of the seal
Over time the seal of the canal can deteriorate and can cause leakage.This may allow bacteria to re-enter the canal and eventually contaminate it and cause a re-infection. This can lead to irritation of the tissues surrounding the root.
Inadequate dental
restoration
If the final restoration is defective or inadequate it may allow bacteria to re-enter the tooth.This situation is called “coronal leakage” and it is a major cause of root canal failure.
Lack of dental expertise
Some treatments can be straightforward and others are more complicated. If a case is complicated or outside the realm of expertise of the dentist, it is best to refer the patient to an Endodontist. Unfortunately, there are no such specialists in Guyana so the next best option would be to refer the case to a more experienced dentist.
Other factors
Sometimes even though the root canal treatment is successful the tooth itself may have a problem.
It may be broken or fractured and this can affect the prognosis of the root canalled tooth. Also, over time the tooth that has undergone root canal treatment may be become brittle predisposing it to breakage or fracture. Thus, it is always advisable to crown a root canalled tooth to reinforce it.
When there is failure of root canal therapy, there are several treatment options.
These include retreatment, endodontic surgery or extraction.
Retreatment is essentially removing the root sealing and filling materials and replacing them with new ones. Endodontic surgery is also referred to as apicoectomy or retrograde root canal therapy.
In this procedure the root tip is accessed through the bone of the jaw. It is then surgically removed along with any infected tissue and a biocompatible material is used to seal off the root.
Extraction is another option and sometimes is the only option as the others may offer a poor chance of success or are not financially feasible.
Just like any other tooth in your mouth those that have undergone root canal therapy are at risk for the tooth decay and gum disease. It is very important that you maintain proper oral hygiene with daily brushing and flossing and regular visits to your dentist.

For more information contact OMNI DENTAL at 295 Quamina Street, Georgetown Tel: 227-0025, Parika Tel: 260-3133 or send emails to nerominifagu @hotmail.com.