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Miscellaneous endodontic instruments. From left: Lentulo spiral, reamer, K-file and H-file. Hand files can provide tactile sensation when cleaning or shaping root canals. This allows the dentist to feel changes in resistance or angulation, which can help determine curvature, calcification and/or changes in anatomy, in which two dimensional radiographs may not always identif
A root end surgery, also known as apicoectomy (apico-+ -ectomy), apicectomy (apic-+ -ectomy), retrograde root canal treatment (c.f. orthograde root canal treatment) or root-end filling, is an endodontic surgical procedure whereby a tooth's root tip is removed and a root end cavity is prepared and filled with a biocompatible material.
It must have enough structure to support restoration. Filling the root canals of the tooth from the crown (orthograde root canal therapy) should be the first treatment option to resolve inflammation caused by the tooth. Periradicular surgery is only considered if the inflammation persists after conventional root canal treatment.
On the other hand, the root canal filling material may be extruded from the apex leading to other complications. [citation needed] The X-ray in the right margin shows two adjacent teeth that had received bad root canal therapy. The root canal filling material (3, 4, and 10) does not extend to the end of the tooth roots (5, 6 and 11).
Fillings fail because of changes in the filling, tooth or the bond between them. Secondary cavity formation can also affect the structural integrity the original filling. Fillings are recommended for small to medium-sized restorations. Inlays and onlays are more expensive indirect restoration alternative to direct fillings.
Nickel titanium rotary file used in dentistry. A nickel titanium rotary file is an engine-driven tapered and pointed endodontic instrument made of nickel titanium alloy with cutting edges used to mechanically shape and prepare the root canals during endodontic therapy or to remove the root canal obturating material while performing retreatment.
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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).