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Video Details
Apical Dentinal Cracks as a Cause of Endodontic Treatment Failure: Microsurgical Diagnosis and Management part 1 of 2

Description:
Non surgical endodontic treatment is a predictable and reliable treatment with high success rates ranging from 86%–98% . Nevertheless, for a variety of reasons, endodontic failure still occurs, and presence of clinical signs and symptoms along with radiographic evidence of periapical bone destruction indicates the need for retreatment. The first and most important step for retreatment planning is to determine the cause of endodontic failure. The failure of the root canal treatment is generally attributed to either residual or resistant intraradicular microorganisms surviving cleaning and shaping procedures or new microorganisms invading the canals via miclroleakage. Rarely some persistent lesions may be attributed to extraradicular infection, foreign body reaction or a true periapical cyst. Moreover, the outcome of root canal retreatment is less favorable than the initial treatment. Endodontic failure related to microorganisms can be caused by procedural errors such as root perforation, ledge formation, separated instruments, missed canals, as well as anatomical difficulties such as apical ramification, isthmuses, and other morphologic irregularities. Nevertheless, a precise diagnosis can be made only after surgery or extraction. A precise inspection of the root apex or resected root surface is one of the best advantages of endodontic microsurgery. It helps identify the cause of endodontic failure, so that causative factors can be removed completely during the surgical procedure. This new lecture is about analyzing the cause of my personal retreatment failures by using microsurgical techniques. It seems that apical dentinal cracks dominate my failures. Preventive measures, risk factors and treatment options are also discussed.

Date Added:
5/14/2012

Author(s):

Antonis Chaniotis, DDS MDSC Antonis Chaniotis, DDS MDSC
Chaniotis Antonis graduated from the University of Athens Dental School (Greece) in 1998. In 2003 he completed the three-year postgraduate program in Endodontics at the Univer...
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Online Videos / General / Endodontics / Apical Dentinal Cracks as a Cause of Endodontic Treatment Failure: Microsurgical Diagnosis and Management part 1 of 2




Questions & Comments
Jasper Ainslie - (1/17/2018 6:38 PM)

thankyou

Robert Burstein - (12/23/2014 9:18 AM)

Any thoughts of management of the boney void with graft material and/or membrane to avoid ingress of epithelial tissue? Great lecture and video thank you.

NAGARAJAN MUTHUSAMY - (3/12/2014 4:37 AM)

Great presentation on peri- apical surgery.very nice.

Maurice Salama - (10/23/2012 7:05 PM)

Clean surgery and great endo. Applause. Dr. Salama

Dimitris Tsanaktsidis - (7/12/2012 10:38 AM)

5* from me . Especially for the Greek Version. Well done!

milind saudagar - (6/30/2012 1:33 PM)

indeed very impressive. with the era of fast rotary and greater taper endodontics, cracks in root are becoming a common feature. we tend to please ourselves radiographically with big huge fillings ignoring the anatomy of the cannal and thus compromising the tooth structure and strength.
very well and neat sealing of the isthmus. only a master can do it.
thanks

Antonis Chaniotis - (5/20/2012 3:53 AM)

Thank you dr. Scholl. I place a pellet in the bone crypt and leave it there until the surgery is finished. High concentration epinephrine anesthetics, pressure hemostasis and epinephrine pellets most of the times would be sufficient. Be carefully with the racellets in a maxillary sinus communication. You can have sterile saline if your dental unit have a Tank for delivering sterile saline. Most of the times the impact air 45 handpiece is used with water . You can perform the final rinse with sterile saline, or use a surgical motor for the apicoecTomy. Piezo surgery units are also an excellent choice!

Paul Scholl - (5/19/2012 8:06 PM)

Nice case. What is the protocol for hemostasis with the pellets? How do you set up your surgical high speed to flow sterile fluid onto the site? Thanks for the informative video

Antonis Chaniotis - (5/19/2012 10:59 AM)

Thank you doctor. Preventive measures and risk factors follow in part II.

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