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Decision-making in the management of ‘failed’ orthograde endodontic retreatment: A literature review with case reports

Decision-making in the management of ‘failed’ orthograde endodontic retreatment: A literature review with case reports. Dariusz Borczyk BDS PhD. Clinical Teaching Fellow in Restorative Dentistry Dentist with Special Interest in Endodontics. Dariusz Borczyk.

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Decision-making in the management of ‘failed’ orthograde endodontic retreatment: A literature review with case reports

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  1. Decision-making in the management of ‘failed’ orthograde endodontic retreatment: A literature review with case reports Dariusz BorczykBDS PhD • Clinical Teaching Fellow in Restorative Dentistry • Dentist with Special Interest in Endodontics

  2. Dariusz Borczyk

  3. Endodonticsis the science and the art... Dariusz Borczyk

  4. Endodonticsis the science and the art...... of the treatment of pulpal and periapical diseases Dariusz Borczyk

  5. Complications

  6. Decision-making Initial Treatment Endodontic Retreatment Retreatment of Retreatment

  7. Complications

  8. Decision-making Initial Treatment Endodontic Retreatment Retreatment of Retreatment should What I do?

  9. Crump & Natkin, JADA 1970, 80, 1341 Cheung, Int Dent J 1996, 46, 131 Reit & Kvist, Int Endod J 1998, 31, 358 Aryanpour et al, Int Endod J 2000, 33, 208 Friedman, Aust Endod J 2000, 26, 104 Kvist, Swed Dent J, 2001, Suppl 144 Kvist & Reit, Int Endod J, 2002, 35, 359 Friedman, Endod Topics 2002, 1, 54 Farzaneh et al, J Endod 2004, 30, 627 Kvist et al, J Endod 2004, 30, 572 Literature review • Paik et al, J Endod 2004, 30, 745 • Saunders et al, J Endod 2004, 30, 177 • Yoldas et al, OOOOE 2004, 98, 483 • Al-Ali et al, Int Endod J 2005, 38, 470 • Peikoff, Aust Endod J 2005, 31, 15 • Lumley et al, Dent Update 2006, 33, 518 • Mohammadi & Khademi, J Clin Dent 2006, 17, 131 • Karabucak & Setzer, Comp Contin Educ Dent 2006, Ascend Dental • Yan, Aust Endod J 2006, 32, 2 • Del Fabbro et al, Cochrane Database Syst Rev 2007, 18, CD005511 • Molander et al, J Endod 2007, 33, 1145

  10. Junior / senior student Experienced / non-experienced dentist General dentist / Specialist endodontist Differences between schools ‘Retreatment behaviours’

  11. Case reports

  12. Case reports

  13. Case reports

  14. Case reports

  15. Case reports

  16. Case reports of ‘failed’ treatments

  17. Case report 1 6 months 21 months 33 months

  18. Case report 2 11 months

  19. Case report 3 2 months

  20. Case report 3 2 years,3 months 6 years

  21. Case report 4 6 months

  22. Case report 5 4 years, 8 months

  23. Case report 6 5 months 1 year

  24. Case report 7 2 years, 7 months 4 years, 9 months

  25. Case report 8 3 months 7 months

  26. Case report 9 3 years, 8 months 10 months

  27. Case report 10 5 months 10 months 1 year, 7 months 1 year, 10 months 3 years, 1 month

  28. Case report 11 5 years, 6 months

  29. Case report 12 1 year, 9 months 4 months 2 years, 10 months

  30. Case report 13 4 months 2 years, 5 months

  31. Patient’s motivation and expectations Dentist’s and patient’s personalities Financial and ‘logistic’ considerations Likelihood of being sued Presence of symptoms Planned restorative treatment Status of adjacent teeth etc. Decision-making depends upon

  32. Conclusions

  33. Conclusions 1. should I do? What consequences of my decision be? What will the

  34. Conclusions 2.

  35. Conclusions 2.

  36. Conclusions 2.

  37. Conclusions 2.

  38. Restrictions in direct application of scientific evidence into dental practice Orthograde retreatment preferable to surgical There can be no difference between ‘failed’ endodontic retreatment and ‘failed’ initial treatment Endodontic retreatment of periodontically compromised teeth not always contraindicated Two-year follow-up may be inaccurateto determine success vs. failure Conclusions

  39. The patient should be fully informed and participate in the clinical decision-making Conclusions

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