Endodontics Insider: Dissertation raises concerns about gen practitioners doing endo

Dear Endodontics Insider,

A dissertation by a Swedish dentist and researcher raised concerns about potential complications of root canal treatment performed by general dental practitioners.

In a series of studies, 30% of patients failed to complete root canal treatment, most often because the tooth was extracted instead. What's worse, half of patients who completed treatment reported pain or discomfort one year later. See more findings in this edition's Insider Exclusive.

Also new in the Endodontics Community, a substance often used to disinfect root canals was injected incorrectly and caused an unusual cutaneous reaction in a 16-year-old girl during endodontic treatment. The girl experienced severe pain and skin changes requiring treatment with plastic surgery.

In another endodontic case-gone-wrong, an endodontic instrument broke and got stuck about 2 mm below the tip of a patient's tooth root. An emergency clinical team used a combination of techniques, including piezoelectric bone surgery, to safely remove the instrument and complete the root canal treatment.

The ADA's SmileCon 2021 meeting took place earlier this month in Las Vegas, and one well-received presentation focused on performing successful root canal treatments. Speaker Dr. Anne Koch from the Harvard School of Dental Medicine gave tips for preventing failure and fracture, including having clear, straight-line access to the root of the tooth.

Imaging is crucial for endodontic diagnosis and treatment planning, and researchers are working to train artificial intelligence (AI) models to identify the location of teeth and pulp cavities on cone-beam computed tomography (CBCT) and micro-CT images. In one experiment, the AI models more precisely labeled the pulp chambers than an endodontic specialist.

Finally, more patients are presenting to dentists with cracked teeth during the COVID-19 pandemic that may require endodontic treatment. In a video interview, Dr. Stephen Abrams walked me through the case of one such stressed out patient he saw earlier this year. Abrams discussed how he provided whole-body care in addition to traditional dental treatment.

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