Preventing Root Canal Perforation by Case Selection

This patient came to Superstition Springs Endodontics in June 2009.  Her general dentist had started RCT on #3 but was unable to locate the MB canal(s).  A perforation was made during the efforts to find the MB canals.  We have taught the generalists in our community that the most successful and fulfilling way to practice endodontics depends upon careful case selection.  Proper case evaluation can:

1.  prevent lost chair time without reimbursement
2.  prevent loss in patient confidence
3.  prevent clinician frustration

The Endodontic Case Assessment Form from the AAE, can help clinicians determine the difficulty level of treatment - before therapy is started. This is how this case should have been classified - prior to starting treatment. 

 

 

 The treatment for this tooth was RCT completion and repair of the iatrogenic damage using Mineral Trioxide Aggregate (MTA).

Fortunately, with good repair materials, the prognosis for a tooth like this is still good.  A 7 year recall finds the tooth in full function and asymptomatic.

However, proper case selection will make your practice of endodontics more fulfilling, less stressful and ultimately, more successful.