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Analyzing Failures

Posted Feb 19 2009 6:08pm
Wow, readers. I am very sorry. This past week was so crazy, I never got a second to post any articles. Let me see if I can knock a few out tonight.

This is an endodontic case that I completed in July. It is tooth #31 and was vital at the start of endo. It had deep caries into the pulp. I was satisfied with the way the case turned out. It was a 2 canal mandibular molar. I do not have any photos of the access, but it looked something like this. Forgive my crude sketch:


















Here is the final radiograph after completion of the endo in July:

















Here is a radiograph I took at recall last week:

















As you can see, the endodontic therapy failed. The mesial canal looks short but this is where the apex locator told me the apex was. There could have been some heme in the canal that caused a false reading and a short instrumentation. Many times, endodontic therapy on vital teeth well work even when not perfect. Necrotic teeth have a slimmer margin for error. I would be interested in searching for literature on this topic. Any of your endo-philes have any ideas on this case? Why else could this case have failed?
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