No Tengo

The Journal of the Australian Society of Endodontology Inc. and the Australian and New Zealand Academy of Endodo ntists

Aust Endod J 2009; 35: 98–107

A S E U N D E R G R A D U AT E E S S AY W I N N E R

Discuss the factors that affect the outcome of endodontic treatment
aej_199 98..107

Akhil Chandra
School of Dentistry, University of Western Australia, Nedlands, Western Australia,Australia

Keywords factor affecting success, prognosis, root canal treatment. Correspondence Mr Akhil Chandra, School of Dentistry, University of Western Australia, 17 Monash Avenue, Nedlands, WA 6009, Australia. Email: dr_aki@bigpond.com doi:10.1111/j.1747-4477.2009.00199.x

Abstract
Factors affecting the outcome of endodontic treatment are discussed from the theoretical viewpoint(microbes, foreign bodies and epithelium) and from a clinical aspect (preoperative factors, intraoperative factors and miscellaneous factors). The following conditions favour endodontic success significantly: the absence of a periapical infection, a well-condensed root filling, the root filling extending to 2 mm within the radiographic apex and not beyond, a satisfactory coronal restoration, use of a rubberdam during treatment and cases involving primary root canal treatment as opposed to retreatment. Other factors have the potential to affect success rates, but these have not yet been quantified. Although there is an array of potential factors that influence the outcome of endodontic treatment, success is most significantly dependent upon the elimination of root canal infection present when treatmentstarts and the prevention of contamination during treatment.

Introduction
Endodontic treatment is primarily the combination of chemo-mechanically preparing the root canal space to facilitate the placement of a biocompatible material that seals the canal throughout its entirity. In doing so, microorganisms and organic material that may decompose and sustain bacterial growth are removed tomaintain or restore the health of the periradicular tissues. This essay intends to primarily discuss the success of endodontic treatment, and the factors affecting the outcome of endodontic treatment, such as microbes, foreign bodies and epithelium, as well as preoperative, intraoperative and other miscellaneous factors.

this goal is difficult to achieve as shown by previous studies (2). Thus, werely upon radiographic and clinical indicators to evaluate the outcome. Abbott proposed several indicators of successful treatment versus treatment failure (Table 1) (1); reviewing these parameters is useful when evaluating endodontic success and the associated variables involved.
Table 1 Success versus failure Success Failure

Defining the outcome – success versus failure
Treatment outcomeclassification, that is, success or failure, is fundamental when evaluating the outcomes that affect endodontic treatment. Inevitably, many variables must be taken into account when assessing the outcome and many cases will not be readily identifiable. In histological terms, endodontic success assumes that there has been a complete repair of the periapical tissues without the presence of inflammatorycells (1). However,
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No clinical signs or symptoms The treated tooth is symptomatic or has of infection or inflammation abnormal appearance following treatment No loss of function The soft tissue responds abnormally to palpation or other examination No radiographic signs of Radiographs reveal that a periapical ongoing pathology lesion has appeared after endodontic treatment A reduction inthe size and A periapical lesion that was density of any previously radiographically evident before existing periapical treatment has failed to heal or has radiolucency become larger A tooth that has been successfully treated should follow the ‘success’ criteria. Conversely, failure of endodontic treatment is generally defined as occurring in the ‘failure’ section (1).

© 2009 The Author Journal...