The Importance of Quality Initial Root Canal Therapy

The following post addresses the importance of good initial root canal therapy. If endodontic treatment fails, there is statistically a lower success rate with retreatment.  If retreatment is necessary, however, seeking out an endodontist to perform the retreatment of a prior root canal can bring long term success. Continue reading below an original post from theendoblog.com.

The Importance of Quality of Initial Root Canal Therapy

It is fair to say that endodontic retreatment has a lower success rate than initial endodontic therapy. This highlights the importance of good INITIAL endodontic therapy.

In a study by Boucher et. al. (2002) to evaluate the quality of endodontic treatment in a French subpopulation of 204 patients, looking at approximately 2,010 obturated canals, found that canals were filled to an acceptable standard 21% of the time.

Chueh et. al. (2003) in a similar study in Taiwan to evaluate root canal filling for length and fill density in 1085 RCT cases found similar results. Their study found that RCT fill and/or length was inadequate 70% of the time.

Gumru et. al. (2011) in a similar study, using a Turkish subpopulation, looked at 459 root filled teeth and found the technical quality inadquate 60.1% of the time.

After looking at the data reproduced by these studies, it would be reasonable to say that the number of endodontic retreatment cases could be reduced by improving the quality of initial endodontic therapy. If we know that initial endodontic therapy has higher success rates than endodontic retreatment, it is our duty to make good treatment decisions and give our patients the best chance for successful initial endodontic therapy. This may mean referral to a specialist on more difficult cases such as molars, RCT through crowns/bridges or cases with calcified canals. Deciding when to refer to an endodontist can be a difficult decision. The AAE has published a case difficulty assessment form to help dental professionals with that decision making process.

Continue reading HERE.

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