Root canal treatment has a 95 percent success rate. 5 percent procedures result in failure for a variety of reasons, some of which are unpredictable. A sign of failure is when, after the procedure, the tissues around the root remain infected and so does the inside of the tooth. Typical symptoms are tooth pain, swelling or soreness in the gums in the area surrounding the tooth.
Sometimes other complications arise like a new infection without symptoms or warning. The success or failure of a root canal treatment can be determined through an x-ray, which will show up signs of inflammation surrounding the tooth. Sometimes complications take years to appear.
Some of the causes of root canal complications are:
- A root canal or part of it has been missed and improperly cleaned or sealed. Residual pulp, if left to remain, tends to re-infect the tooth.
- Some canal systems are convoluted with branches extending sideways. These are occasionally difficult to detect. A hidden, unattended branch could remain dormant and a constant source of infection.
- Some branches may be noticed but could be inaccessible.
- If the dentist has underestimated the length of the root canal, the endodontic file and filling material will not penetrate to the end of the tooth. The remaining infected tissue will inevitably result in a tooth abscess.
- A small, existing crack at the root of the tooth if undetected, will permit the ingress of bacteria and re-contaminate the tooth.
- The tooth may be brittle since the pulp is dead, and might fracture the root during the filing process. Endodontic surgery will have to remove the fractured root to save the tooth, but saving it is highly unlikely.
- An inadvertent perforation during filing, if left unsealed, will permit the ingress of bacteria.
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