Complications may occur during and after endodontic treatment, which may be due to negligence of the operator. The surgical treatment of a case presenting pain and persistent pus discharge and swelling due to the extrusion of the root canal filling to the base of the nasal floor between left maxillary lateral and canine teeth is presented in this report.
First, carelessness was during root canal treatment that was over obturated and second time during extraction in which overextended gutta-percha remained in the bone, caused the complications like pain, persistent pus discharge, and headache. Clinicians should be aware of the fact that endodontic instruments and filling materials solid or liquid can be extended in such a degree that can lead to neurological or sinus complications.
The main objective of endodontic treatment is to provide hermetic obturation of the root canal system with an inert, biocompatible, and dimensionally stable filling material. According to a satisfactory obturation of the root canal, the filling material and the endodontic instruments should be limited to the root canal without extending to periapical tissues or other neighbouring structures Poveda et al.
There are numerous examples reported in the literature that cite and document many disabling complications to the alveolar bone, neurovascular anatomy, and maxillary sinus following overextension of root canal filling materials. Neural complications, a consequence of endodontic obturation as well as other server outcomes to overextended obturating material, are serious problem.
These injuries require a thoughtful strategy for prevention during endodontic procedures as well as a responsible systematic approach to management, should the outcome of endodontic therapy produce an injury. This monograph will focus on measures that can prevent obturation mishaps which occur under the most vulnerable circumstances during the course of endodontic therapy. Endodontic mishaps or procedural accidents are those unfortunate occurrences that happen during treatment.
Recognition of such incidence is the first step in its management. Correction of such mishap may be accomplished in one of several ways depending on the type and extent of procedural accident. Endodontic mishaps are either a access related, b instrumentation related, c obturation related, or d miscellaneous. A 30 years male patient reported to the Department of Conservative Dentistry and Endodontic, Faculty of Dental Sciences, CSM Medical University, Lucknow, with a chief complaint of continuous pain and heaviness in the infraorbital region and pus discharge.
His medical history was insignificant and dental history revealed that his maxillary lateral incisor and canine of left side got fractured due to trauma 1 year back. He had been treated in a private clinic with root canal treatment, but patient was not totally asymptomatic.
After 10 months, he had developed swelling and pain with pus discharge in upper left anterior region. The Consultant Dentist in that private clinic had extracted both the teeth but pus discharge continued and pain was present, which was refractory to several courses of antibiotics and analgesics. Intraoral examination showed sinus in relation to maxillary left lateral incisor and canine region with unhealed sockets.
Extra oral examination showed slight swelling in the left maxillary lateral incisor and canine region. Radiograph revealed the foreign body [gutta-percha] in the upper left anterior infraorbital region near the nasal floor [ Figure 1 ].Anesthesiology ; 2 We have emailed you at with instructions on how to set up a new password. If you do not receive an email in the next 24 hours, or if you misplace your new password, please contact:. To get started with Anesthesiology, we'll need to send you an email.
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Login Log in to access full content You must be logged in to access this feature. Join today! Forgot password? Forgot username? View Access Options. Advanced Search. View Full Size. Sloan Curry Youngblood, M. Accepted for publication April 10, Article Information. Anesthesiology 8Vol.An audience of priesthood and women leaders enjoys listening to instruction from Elder Dieter F. Uchtdorf at a stake center in Montevideo, Uruguay.
When Elder Dieter F. Uchtdorf sat down a few days ago with the Church News, he was approaching, in airline speak, the final leg of his travels in Uruguay and Chile.
But if the year-old member of the Quorum of the Twelve Apostles was beginning to tire, he hid it well. The next day would be unforgettable, he told the Church News with trademark enthusiasm. He would spend Saturday, February 15, in a Santiago stake center filled with missionaries and local Church leaders who shared his commitment to build the Church in Chile. With no fear, they ask questions concerning their own lives. Technology, of course, allows for real-time communication between Church headquarters and the far corners of the world.
But nothing, said Elder Uchtdorf, equals being with Latter-day Saints and missionaries in their home countries. Elder Dieter F.Auxiliary dependent variable comsol
Uchtdorf and Sister Harriet Uchtdorf enjoy the temple grounds after visiting the Church offices in Santiago, Chile, during their recent February tour of Chile and Uruguay. As a man whose life has been largely defined, professionally and ecclesiastically, by his global sojourns, Elder Uchtdorf knows well the first lesson of travel: expect the unexpected.
Endodontic Mishaps in detail
Local leaders in Uruguay introduced him to a Latter-day Saint dentist who operated her Montevideo practice out of her home. The Uchtdorfs stopped by her office in between their Sabbath-day meetings in two different wards. The dentist and her husband, they learned, were the parents of six children, including a seven-year-old daughter with special needs named Emma, who was in the hospital recovering from major surgery.
And Harriet and I had the chance to minister to her family. We talked together, took photos, and enjoyed our time together. As music lovers, the Uchtdorfs were thrilled by the children, who play different musical instruments; two violin, one piano, one guitar, and one flute. Two days later, the Uchtdorfs learned Emma had arisen from her hospital bed and asked for something to eat.
Elder Mark A. It was beautiful to see this intersection of prayers offered from a faithful family and prayers answered from a loving Heavenly Father. Otherwise, I would not have met that special family. But no device or app, he said, can replace direct fellowshipping with Latter-day Saints in their own homes and meetinghouses. She asked him why he was traveling far from his home and about the role of a Latter-day Saint Apostle. I personally need that contact so I can better relate with the people and see how the Church can better help.Endodontic mishaps or procedural accidents are those unfortunate occurrences that happen during treatment, some owing to inattention to detail, others totally unpredictable.
It is important to know how to recognize them, how to correct them, how they affect prognosis, and how to prevent them. May have dentolegal consequences. These can be minimized or avoided by providing patients with adequate information prior to the endodontic procedure. Recognition Patient who continues to have symptoms after treatment. The error may be detected after the rubber dam has been removed.
Safest approach, even if embarrassing, is to explain to the patient what happened and how the problem may be corrected. Attention to detail and obtaining as much information as possible before making the diagnosis. Baseball rule ofthree strikes and yer out - before making a definitive diagnosis, obtain at least 3 good pieces of evidence supporting the diagnosis. Once a correct diagnosis has been made, the embarrassing situation of opening the wrong tooth can be prevented by marking the tooth to be treated with a pen before isolating it with a rubber dam.
Some are not easily accessible or readily apparent from the chamber. Lack of knowledge about root canal anatomy or failure to adequately search.Jquery add active class to current menu item codepen
During treatment, an instrument or filling material may be noticed to be other than exactly centered in the root. Magnifying loupes and the microscope may be used to clinically determine the presence of additional canals. Correction Re-treatment should be attempted before recommending surgical correction.
Prognosis Decreased and will most likely result in treatment failure. In 2 canals with a common apical exit if adequate seal is achieved in both canals - bacterial content in a missed canal may not affect the outcome for some time.
Knowledge of root canal morphology and knowing which teeth have multiple canals is a good foundation. A preexistent infraction becomes a true fracture when the patient chews on the tooth weakened by an access preparation. Recognition Usually by direct observation.Before proceeding to endodontic treatment planning, the clinician must ask himself the following questions to avoid falling into one of these complications:.
If a clinician asked himself these questions and answer them correctly, and acted upon these answers, many complications would be avoided and never happened. Additional canals in teeth can be missed in occasion. Canals commonly missed are additional canals in mesial root of maxillary molars, distal roots of mandibular molars.
Second canal in lower incisors, second canals and bifurcated canals in lower premolars and third canal in upper premolar also can be missed. Always pay attention and expect extra canals. Porcelain crowns are more susceptible to chipping and fracture. Use of water-cooled, smooth diamond bur can prevent this situation. And not forcing the bur into the restoration can also prevent such incidence. During locating the canal orifice and removing tooth structure a perforation may occur.
Following etiological factors may be the likely cause of perforation:. Early detection of perforation is one of the critical factors playing a role in better prognosis of the case. Signs and symptoms of perforation may include:. Access cavity perforation occur while searching for canal orifices. Each is created and managed differently. Direct perforation occur when searching for canal orifice.
While stripping perforation occur on lateral coronal part of the root and is not easily accessible. The bleeding should be stopped, and MTA applied to the perforation site.
Because it take MTA 3 hours to set, it should be sealed with fast-setting cement. The other canal orifices should be protected by placing paper points or an instrument in the canals to prevent blockage. If MTA can not be applied, it is best to stop the bleeding, place calcium hydroxide over the perforation or the wound, then place temporary filling and set an appointment with the patient.
The sooner the better. The perforation will be dry on the next appointment, then MTA can be applied and treatment continued. Most common accidents during cleaning and shaping of root canal system involve ledge formation, artificial canal creation, root perforation, instrument separation and extrusion of irrigant solution into periapical tissue.
Ledge is the created when the original path of root canal is lost. Several causes lead to ledge formation:.Destiny child global mods
Such action can be prevented by adhering to points discussed earlier in ledge formation prevention. First, dentist must confirm the occurrence of perforation, using either apex locator, paper point or radiograph with file in position. MAP system syringe is used for placement of material at the perforation site.
Root perforation can occur at different levels apical, middle, or cervical which means different etiology and management plan. Using paper points, if blood appear at the tip of paper points this an indicative of apical perforation.
Although many sealing materials have been tried, MTA showed promising results. Also called lateral perforation, is perforation through the middle third of root structure. Using excessive force over file lead to ledge formation and eventually perforation through the root.Here is our list of the top funny dentistry stories you might not have heard.
This gem of a story was pulled from notalwaysright. To set up the scene, imagine a doctor calling into a surgical product hotline while his patient is sitting there, mouth agape, and potentially under anesthesia…but, maybe not.
You go to the right to tighten, and the left to loosen. Righty tighty, lefty loosey! This one from guy-sports. What have you been eating? I loved it so much I now put it on everything: meat, toast, fish, vegetables, everything.
Hollandaise sauce is made with lots of lemon juice, which is highly corrosive. A hospital consulting dietician, a smart nurse and a wedding cake — What could make a better story? This one was pulled from guy-sports. Red meat is terrible. Fizzy drinks attack your stomach lining. Chinese food is loaded with MSG.
Vegetables can be disastrous because of fertilizers and pesticides and none of us realizes the long-term damage being done by the rotten bacteria in our drinking water. However, there is one food that is incredibly dangerous and we all have, or will, eat it at some time in our lives. Now, is anyone here able to tell me what food it is that causes the most grief and suffering for years after eating it?
According to a Huffington Post news story, the Swedish inmate broke out of prison because he wanted to go to the dentist. Talk about dedication to dental health! The man told news authorities that he had been complaining about the toothache for days and just could take it anymore even though he was scheduled to go the following day.
The inmate turned himself in after being treated and apparently as a result, his one-month prison sentence was only extended one day. This wonderful tale is pulled from a forum where dental students contributed stories.Woman With No Teeth Hides It with Chewing Gum - Never Seen A Doctor
A friend tells this story about a stressed dental assistant taking an extremely important practical exam. A dental assistant is taking the exam, which is graded by an observer and includes input from the student dentist.
The doctor is working on an amalgam and the dental assistant is required to hand him instruments and materials he needs without him asking for them. Righty-Tighty, Lefty-Loosey This gem of a story was pulled from notalwaysright. Which way do I turn it? Move the wrench to the right? Righty tighty, lefty loosey. All finished? The story: A man visits his dentist because his mouth feels strange. The story: According to a Huffington Post news story, the Swedish inmate broke out of prison because he wanted to go to the dentist.
The Fly in the Dental Exam This wonderful tale is pulled from a forum where dental students contributed stories.
Do you have any stories to share? Please do! Tell your story in the comments. Since retirement is not that farAre you planning a vacation? Along with packing and booking plane tickets, hotels and tours and taking care of your household, have you ever considered how you can avoid or manage any dental mishaps while you are away from home?
But the health of your mouth should always be considered. The best way to prevent any potential problems is to maintain your oral health with daily home care and regular visits to your dentist. Take care of these concerns immediately to avoid pain and infection while you are away.
Make sure to have any dental surgery you may need completed well in advance of your trip, to avoid having abscesses or post surgical complications once you have left the country or at least the comfort of your own home. If you break a tooth or you develop an infection while away, make sure to seek treatment immediately. As a general rule, do as little as possible to manage the situation until you get home. An acute infection will require an antibiotic.
A broken tooth can be dressed temporarily to relieve some pain and to smooth any rough edges. Make certain you make an appointment with your dentist once you are home from vacation. The sooner one looks after any dental emergency, the faster you will be on the road to recovery and a healthier smile. The travel container you keep your toothbrush in should be large enough to provide air circulation. Before and after your trip, be sure to clean your case.
To avoid bacteria, take your toothbrush out of its travel case as soon as you reach your destination. Standing your brush upright in a cup will allow the water to drain away from the bristles.Node fetch
Take your toothbrush out of its travel container as soon as you get home. Consider a collapsible toothbrush, a disposable tooth flosser or a roll of floss because they are easy to fit into your purse or carry-on.
Always remember to wash your hands well before handling your toothbrush or flossing your teeth. Use bottled or boiled water instead. Another tip is to pack some tooth treats to help you keep your mouth clean. Sucking sugarless candies with green tea extract, or drinking green tea, can protect your teeth.
Research at Pace University suggests green tea may help to destroy the bacteria that cause cavities. How to avoid dental mishaps while on vacation is an important topic, especially during this time of the year. As we are in the middle of the summer, it is importan to stay healthy for your upcoming travel. Click me Have you ever had any dental emergencies while on vacation? We would love your input and feedback.
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