Risk management in endodontics.
BACKGROUND
Endodontic claims are the most frequently filed malpractice claims in dentistry. The aim of this study was to categorize and review errors and complications related to endodontic procedures that resulted in legal actions against the treating practitioner.


METHODS
All dental malpractice complaints reported to the Medical Consultants International Company (MCI) in Israel between the years 1992-2008 were retrospectively analyzed according to a structured form. All complaints were categorized as either financial risk bearing (eg, justified) or financial non-risk bearing (eg, nonjustified). The treatment errors that were found in the files were categorized according to phases of treatment: preoperative, intraoperative, and postoperative errors.


RESULTS
A total of 720 complaints were analyzed including 520 complaints (72.2%) that were found to be justified and 200 complaints (27.8%) that were judged as not justified. Most of the treatment errors occurred during the intraoperative phase. In lower anterior teeth and in cases involving more than 1 tooth, significantly more errors were found during instrumentation and root canal filling (P < .05). There was a similar distribution of operator errors and of negative outcomes for teeth with elective endodontic treatment and teeth with endodontic treatment as a result of a pathologic process.


CONCLUSIONS
The technical skills of the dental practitioners performing root canal treatments require improvement. All possible risks and complications should be considered and explained to the patient before treatment.
Givol
Navot
N
Department of Oral & Maxillofacial Surgery, Chaim Sheba Medical Center, Tel Hashomer, Israel. navotgivol@gmail.com
Rosen
Eyal
E
Taicher
Shlomo
S
Tsesis
Igor
I
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002983:Clinical Competence; D003792:Dental Records / Q000331:legislation & jurisprudence; D003793:Dental Restoration, Permanent / Q000009:adverse effects; D003951:Diagnostic Errors / Q000706:statistics & numerical data; D017558:Elective Surgical Procedures / Q000706:statistics & numerical data; D004708:Endodontics / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007258:Informed Consent / Q000331:legislation & jurisprudence; D007431:Intraoperative Complications; D007557:Israel; D008297:Male; D008318:Malpractice / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data*; D019300:Medical Errors / Q000706:statistics & numerical data; D008875:Middle Aged; D012189:Retrospective Studies; D012308:Risk Management / Q000706:statistics & numerical data*; D012387:Root Canal Filling Materials / Q000009:adverse effects; D018915:Root Canal Preparation / Q000009:adverse effects / Q000295:instrumentation; D012390:Root Canal Therapy / Q000009:adverse effects; D055815:Young Adult
D012387:Root Canal Filling Materials