Lesson 1: Why do endodontically treated teeth fail?

Key concepts in endodontics: Understanding why teeth fail and achieving predictable success

Overview 

This video introduces fundamental concepts in endodontics, focusing on the factors that contribute to tooth failure after root canal treatment. It emphasises the importance of a holistic approach, considering both endodontic and restorative aspects to achieve long-term success.

Key topics covered

• Classifying teeth based on restorability and periodontal support: "Green" (restorable), "Red" (non-restorable), and "Amber" (compromised)
• The significant role of restorative factors in the long-term survival of endodontically treated teeth
• The impact of remaining dentin thickness on tooth resistance to fracture
• The influence of proximal contacts and tooth position in the arch on long-term prognosis
• Key criteria for successful endodontic treatment: pre-operative pulp status, thorough cleaning and obturation, and a well-sealed coronal restoration
• Understanding the ferrule effect and restorability of the tooth before initiating endodontic treatment

Clinical relevance 

The video underscores the critical need for dentists to shift their thinking towards a restorative mindset in endodontics. Recognising the limitations of compromised teeth ("Amber") and understanding how endodontic procedures impact the tooth's restorability allow clinicians to make informed treatment decisions and improve long-term outcomes.

Learning outcomes

After watching this video, dentists will be able to:

• Assess teeth holistically, considering both endodontic and restorative factors in treatment planning
• Identify key criteria that influence the long-term success of root canal treatments
• Evaluate the restorability of teeth based on remaining tooth structure
• Incorporate restorative considerations into their endodontic techniques to minimise the risk of tooth failure