Healing after endodontic therapy is monitored by strict criteria based on clinical examination and interpretation of periodic radiographs. Absence of pain, swelling and other symptoms including sinus tract; together with a radiological evidence of normal periodontal ligament space around the roots; all indicate success.
However, endodontic FLARE-Ups may occur for several reasons. The main reason for FLARE UP or non healing after root canal therapy is the presence of bacteria in the root canal system. Presence of anatomical complexities in the apical third of the roots renders total elimination of bacteria ineffective or even impossible. Failure to address these anatomical complexities negatively affects prognosis.
FLARE-UP in endodontics is a true emergency. Pain and swelling may be so severe that an unscheduled patient visit and treatment are required.
Establishing causes of FLARE-UP, their management, and the precautions to be taken to prevent their occurrence have a great role in clinical outcomes and the factors that influence success.
Objectives
- To assess the reasons for treatment failure and the best options for its management.
- To identify the role of residual bacteria in endodontic FLARE-UP.
- To understand how inability to deal with anatomical complexities of root apex negatively affects prognosis.