Root canal success criteria

J

Jas

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Hi,

Is it possible a root canal treatment has failed when there is no apparent evidence on a radiograph together with no signs of inflammation?

I ask this because I have had 2 molars that showed no evidence of infection on an x-ray or produced any signs of inflammation yet when apical surgery was done I was told by the oral surgeon the teeth were infected.

I'm still struggling with pain in that region but I am told there is no infection (as per radiography) so I am somewhat perplexed.

Is there official documentation on this subject?

Many thanks.

Jason
 
S

ScaredyCat22

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Hi I am not a dentist and do not know of any documentation but only in my unfortunate personal experience yes a root canal can fail and still look good on an xray. tiny little accessory canals can be missed and not show on xray. my infection never showed on an xray and it was not til the dentist opened my tooth that he saw the infection. also if a tooth is cracked down to the root then it is not likely to have a successful root canal even though cracks will rarely show on an xray.
 
J

Jas

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Hi I am not a dentist and do not know of any documentation but only in my unfortunate personal experience yes a root canal can fail and still look good on an xray. tiny little accessory canals can be missed and not show on xray. my infection never showed on an xray and it was not til the dentist opened my tooth that he saw the infection. also if a tooth is cracked down to the root then it is not likely to have a successful root canal even though cracks will rarely show on an xray.

Thanks ScaredyCat22.

When you say your dentist opened up your tooth do you mean you underwent apical surgery or the removal of a crown or the redoing a root canal treatment etc.?
 
S

ScaredyCat22

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Thanks ScaredyCat22.

When you say your dentist opened up your tooth do you mean you underwent apical surgery or the removal of a crown or the redoing a root canal treatment etc.?

I had not yet had a root canal at the time. I had a very large, deep, old, amalgam filling replaced with a composite filling and a pin. I had no pain at all before that.
I did not know it at the time but the pin cracked my tooth. as soon as the Novocain wore off from the filling I was in pain. no crack showed on my xray and no need to root canal showed either so I ended up getting a $1200 crown which they said would help my pain. It didn't. the pain got worse. no abscess ever formed and no infection showed on xray. they then drilled right through my crown and began root canal. upon getting inside my tooth the dead infected pulp was visible though it never showed on xray. I was put on 10 days of antibiotics and my tooth left open to drain. 10 days later they finished the root canal. I still had pain. 4 days ago I went to an oral surgeon to have this tooth extracted because after 3 months of pain I could not live this way anymore. since my root canal was recent and my tooth did not have time to get brittle yet he was easily able to get it out all in one piece instead of the usual breakage that occurs in root canaled teeth. upon it's removal he told me that I did the right thing, nothing could have saved it, it was fractured all the way to the root.
 
J

Jas

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What a nightmare! I have heard of cases of people extracting most of their teeth only to still be stuck with the pain.
 
M

Mugz

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I'm not a dentist either but what I have been told by my dentist regarding continued pain in a previously RCT tooth is that most xrays are 2 dimensional. Teeth are not. Unless you have a 3 D xray taken of your tooth like a cone beam ct scan it is not possible to see everything going on with a painful tooth, especially tiny cracks that can cause pain and lead to infection and that infection and inflammation isn't always seen on xrays and a tooth may sometime appear normal when it really isn't. That is what I've been told but again, I am NOT a dentist and I am sure it depends on the imagining being used and the symptoms you are having and the treatment that has been done to the tooth. Hopefully a dentist will come along and clear up any confusion....hope I haven't added to it!:)
 
S

ScaredyCat22

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What a nightmare! I have heard of cases of people extracting most of their teeth only to still be stuck with the pain.

There is actually a person who posts on this forum sometimes who did have their root canaled teeth extracted and still has pain anyway. and yes it is horrid to spend all that money and instead of getting help end up in worse and worse pain every time.
I still have some pain but it is minor compared to what I had before I got rid of the tooth.
 
C

comfortdentist

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Root canals properly performed or at least decently done are very successful. The alternative is an extraction. I have seen some that looked fine on a radiograph but nevertheless were infected and required an extraction so it is possible but unlikely.
 
S

ScaredyCat22

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Really I believe the only criteria for a successful root canal is that after some amount of healing time you are 100% pain free and able to use the tooth for chewing. no matter how perfect it looks in an xray if it still hurts, aches for no reason like before you had it root canaled, and you can't eat on it then to me that is not successful.
 
carole

carole

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Root canal treatments can take varying times to heal, some are painfree straight away others can take months to settle. There is no hard and fast answer to this as everyone is different. I have had two rct's in the last couple of years the first one that was acutely infected and had been for a long time once the rct was started I was out of pain and no further problems.

The second one I had got infected and treated within a couple of months of it starting, as soon as I started to thaw out I was in pain which got worse over the next couple of days. I had antibiotics and it settled for a few weeks then flared up again. I did have this one re-treated and last year got a crown on it. Sometimes I get the odd little rumble from it but nothing that worries me or requires pain meds of any kind. So even in the same mouth different teeth react differently.

Sorry my only advice is get an endodontist to preform rct's if you can afford it, if not make sure your dentist is capable of doing a good job. :butterfly:
 
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