Factors associated with endodontic treatment failures.

Area of Science:

• Dentistry
• Endodontics
• Microbiology

Background:

• Endodontic treatment aims to eliminate intraradicular infection and prevent periradicular disease.
• Treatment failures can occur despite meticulous procedures, necessitating identification of key etiological factors.

Purpose of the Study:

• To identify the primary factors contributing to endodontic treatment failures in cases without advanced periodontal disease or structural complications.
• To investigate the correlation between bacterial presence, periradicular status, and root canal filling extent with treatment outcomes.

Main Methods:

• Clinical, radiographic, and histobacteriological analysis of 236 endodontic treatment failures.
• Exclusion of cases with advanced periodontal disease, postperforations, or fractures.
• Assessment of bacterial infection, periradicular rarefaction, and root canal filling apical extent.

Main Results:

• A significant correlation was observed between bacterial infection within the canal system and the presence of periradicular rarefaction.
• Persistent bacterial infection in the canal space and/or periradicular tissues, along with preoperative periradicular rarefaction, were identified as major factors for failure.
• The apical extent of root canal fillings (underfilled, flush-filled, or overfilled) showed no correlation with treatment failures.

Conclusions:

• The persistence of bacterial infection is a critical determinant of endodontic treatment failure.
• Preoperative periradicular rarefaction is a significant indicator associated with endodontic treatment failure.
• Root canal filling length is not a primary factor influencing the success or failure of endodontic treatment.