The following factors need to be considered should pain occur following sealing of the root canal system.
High restoration Overfilling Underfilling Root fracture
Once obturation of the root canal space has been completed, restoration of the rest of the tooth can be carried out. The occlusion must be checked for interferences, to avoid an apical periodontitis, or worse, a fractured tooth.
Root fillings that are apparently overfilled do not as a rule cause more than mild discomfort after completion. The most likely cause of pain following obturation of the root canal space is the presence of infected material in the periapical region. The significance of an underfilled root canal is whether the canal has been properly cleaned and prepared in the first instance, and infected debris is still present in the canal. Postendodontic pain in these circumstances may well be due to inadequate debridement of the canal.
Removal of an overextended root filling is rarely completely successful and the options left are as follows:
Prescription of analgesics and, if the pain is more severe and infection is present, antibiotics.
An attempt at removal of the root filling and repreparation of the root canal.
Periradicular surgery and apicectomy.
Root fracture
High restoration Overfilling Underfilling Root fracture
Once obturation of the root canal space has been completed, restoration of the rest of the tooth can be carried out. The occlusion must be checked for interferences, to avoid an apical periodontitis, or worse, a fractured tooth.
Root fillings that are apparently overfilled do not as a rule cause more than mild discomfort after completion. The most likely cause of pain following obturation of the root canal space is the presence of infected material in the periapical region. The significance of an underfilled root canal is whether the canal has been properly cleaned and prepared in the first instance, and infected debris is still present in the canal. Postendodontic pain in these circumstances may well be due to inadequate debridement of the canal.
Removal of an overextended root filling is rarely completely successful and the options left are as follows:
Prescription of analgesics and, if the pain is more severe and infection is present, antibiotics.
An attempt at removal of the root filling and repreparation of the root canal.
Periradicular surgery and apicectomy.
Root fracture
The forces needed to place a satisfactory root filling, using the lateral compaction of guttapercha technique, should not be excessive; too much pressure increases the risk of root fracture. The most common type of fracture is usually a vertical one and the prognosis is poor. Extraction, or sectioning of the root in the case of a multirooted tooth, is all that can be recommended.