REVISION OF PREVIOUSLY TREATED ROOT CANAL SYSTEMS

1. Broken files
2. Inadequate cleaning and shaping of root canal system
3. Unsatisfactory obturation

TYPES OF REVISION OF PREVIOUSLY TREATED ROOT CANAL SYSTEMS

● surgical or non surgical

● Revision of treatment

● Only done on symptomatic cases or change in the size of the lesion

● If the tooth is still symptomatic after the revision, redo the RCT

● Focused on the iatrogenic problems:

REVISION OF PREVIOUSLY TREATED ROOT CANAL SYSTEMS

a. Retrieval
- Remove broken file
- Use instruments to remove
- Difficult without microscope

b. Bypass
- insert new file past the broken file in order for you to complete cleaning the canal, it is fine to leave file inside and if it is inside the apical 3rd and the canal is clean, the file can act as part of the obturating material

what to when there is a Broken files

Inadequate cleaning and shaping of root canal system

Inadequate cleaning and shaping of root canal system

• Underfilled

• Overfilled

• Underextended

• Overextended

TYPES OF Unsatisfactory obturation

if the obturating material reached the apex, but there are still gaps within the canal.

Underfilled

Properly filled but has gone beyond the root apex

Overfilled

properly filled but does not properly fill the root apex

Underextended

has gone beyond the root apex (usually combined w/ others (e.g. - underfilled and overextended)

Overextended

● Choosing the best coronal restoration should be done prior to treatment

● Coronal leakage = failure of root canal treatment

● Not all RCT needs crowns, but it does depend on the size of the cavity after caries removal and access preparation

Coronal Restoration