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After endodontic therapy has been executed, or re-executed, successfully, and the canals can no longer provide a nutrient-rich habitat for microbes, [31] the issue of bone healing comes into focus. Ostensibly, then, for regeneration to occur, the root canal system must have been decontaminated and further access to microbial invasion must be ...
Root canal treatment (also known as endodontic therapy, endodontic treatment, or root canal therapy) is a treatment sequence for the infected pulp of a tooth that is intended to result in the elimination of infection and the protection of the decontaminated tooth from future microbial invasion.
An unusual root canal shape, complex branching (especially the existence of horizontal branches), and multiple root canals are considered as the main causes of root canal treatment failures. (e.g. If a secondary root canal goes unnoticed by the dentist and is not cleaned and sealed, it will remain infected, causing the root canal therapy to fail).
Periapical periodontitis of some form is a very common condition. The prevalence of periapical periodontitis is generally reported to vary according to age group, e.g. 33% in those aged 20–30, 40% in 30- to 40-year-olds, 48% in 40- to 50-year-olds, 57% in 50- to 60-year-olds and 62% in those over the age of 60. [13]
But, Ingle and Zeldow have observed that 80 percent of the initially infected root canals increased to 95.4 percent at the second appointment, 48 hours later. Although a considerable reduction in bacterial cell by instrumentation and irrigation, viable bacteria can still be found in at least half of the cases. Canal Grafting (CG)
A failed root canal treatment may also create a similar abscess. A dental abscess is a type of odontogenic infection , although commonly the latter term is applied to an infection which has spread outside the local region around the causative tooth.
Risk of occurrence of a phoenix abscess is minimised by correct identification and instrumentation of the entire root canal, ensuring no missed anatomy. Treatment involves repeating the endodontic treatment with improved debridement, or tooth extraction. Antibiotics might be indicated to control a spreading or systemic infection.
The infected tissue of the periapical cyst must be entirely removed, including the epithelium of the cyst wall; otherwise, a relapse is likely to occur. Root canal treatment should be performed on the tooth if it is determined that previous therapy was unsuccessful.