Do procedural errors cause endodontic treatment failure?
BACKGROUND
This article reviews the effect of endodontic procedural errors, such as underfilling, overfilling, root perforations and separated instruments, on the outcome of endodontic therapy.


METHODS
Filling the root canal more than 2 millimeters from the radiographic apex (underfilling) or beyond the radiographic apex (overfilling), perforations of the root canal system and instrument separation are possible complications of endodontic therapy. Although these procedural errors may have different causes, they all may affect the outcome of treatment.


RESULTS
Endodontic procedural errors are not the direct cause of treatment failure; rather, the presence of pathogens in the incompletely treated or untreated root canal system is the primary cause of periradicular pathosis. Procedural errors typically are due to several factors. Among them is a lack of understanding of the root canal anatomy, the principles of mechanical instrumentation and tissue wound healing.


CONCLUSIONS
Procedural errors impede endodontic therapy, thus increasing the risk of treatment failure, especially in teeth with necrotic pulps and periradicular lesions. However, procedural errors often are preventable.
Lin
Louis M
LM
Department of Endodontics, New York University College of Dentistry, New York, NY 10010, USA. lml7@nyu.edu
Rosenberg
Paul A
PA
Lin
Jarshen
J
D001424:Bacterial Infections / Q000150:complications; D003762:Dental Instruments / Q000009:adverse effects; D019232:Dental Restoration Failure; D006801:Humans; D019300:Medical Errors; D012389:Root Canal Obturation / Q000009:adverse effects; D012390:Root Canal Therapy / Q000009:adverse effects*; D014092:Tooth Root / Q000293:injuries