What complications can occur during root canal treatments?

Watch Dental Video about Root Canal Treatment Complications

These are issues that may occur during a root canal treatment – undesirably so!

We will only discuss special complications here; general treatment complications such as nausea or vertigo after local anesthesia are not mentioned.

The most frequent complication occurs when not all root canals are properly filled; as you can see in the video, the tooth has 4 canals and only 3 are filled.

Also, frequently, canals are not filled completely down to the tip of the root.

The reasons for “not filling down to the tip of the root” are manifold:

  • severely curved canals
  • the break of a root canal instrument
  • an inexperienced practitioner

Other complications during root canal treatments are the perforation of the canal/the crown of the tooth – usually resulting in an extraction of the same.

The abovementioned “instrument break” is also a complication that is not that rare; it may be prevented if the instruments are exchanged on a regular basis.

Root Canal Treatment Complications

Root Canal Treatment Complications

Overfilling the canal is another complication; it is particularly unpleasant if the teeth border on the maxillary sinus or the nerve-canal, as pain and inflammations may result. The excess material does not always have to be removed. A removal of the material should be done if you experience pain and/or if the bone reacts with an inflammation – this is checked through semi-annual X-ray images.

Excess material should also be removed if it is located near the mandibular nerve or the maxillary sinus – even if there is no pain.

In the video "Complications During Root Canal Treatments", you see how, during a root canal treatment, filling material is unintentionally pressed into the nerve-canal of the lower jaw. Dark discolorations of the tooth after a root canal treatment are indicative of blood and careless work during the treatment.

Normally, the canal should be clean and free of blood and bacteria. If this is not the case, bacteria will break down the blood and the iron present in the blood pigment hemoglobin will darken the tooth.

All these complications can be avoided if a dental dam, optical magnification, and clean, well maintained instruments are used.

The risk of badly filled teeth is the occurrence of a bone infection and/or cyst even after several years; patients often talk about a bacterial focus, not really knowing where exactly it is located.

Here you see a cyst that has formed years after a bad root canal treatment. The cyst has a blue edge – one can clearly see how the cyst has pushed the nerve, which passes through the lower jaw (the red border), to the side. This resulted in the patient complaining about a tingling sensation in the lower lip.

Instrument Break - Lentulo

Instrument Break - Lentulo

The cause of this failed root canal treatment was, among other things, a broken instrument. This is another complication in root canal treatments that was already mentioned. You see the white line in the anterior root? That is part of an instrument, which is why the canal was not filled any further.

An X-ray image is used for simple quality control. Here you see a dental X-ray made of a badly filled tooth (on the right) and a well filled tooth on the left. On the left, the canals are homogenously tight, conical, and filled all the way down to the root tip (the white line in the X-ray).

For an experienced practitioner, a root canal treatment is a simple and reasonable therapy for long-term maintenance of teeth. If the root canal treatment is executed well, the tooth may render good services for decades – if not one’s entire life.

Click here to see the video: Root Canal Problems


This post is also available in: German

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