Common Operative Procedural Errors and Clinical Factors Associated with Root Canal Treatment

Abstract Operative procedural errors must be well analyzed in order to avoid influence negatively the root canal treatment (RCT) prognosis. The successful RCT prevents tooth loss and avoids pain and apical periodontitis. This review aimed to categorize common operative procedure errors and clinical factors associated with RCT. Based on this, will be approached common errors of procedures within the clinical operative sequence: endodontic treatment planning, pulp and periapical disease diagnosis, anaesthesia, access cavity preparation, isolation with rubber dam, root canal preparation, root canal filling and retreatment, restoration of endodontically treated teeth, postoperative pain, follow up of endodontically treated teeth. The professional must remind that in each phase of RCT an operative error may have adverse implication on prognosis, and these errors characterize risk factors to failure. The knowledge of probable operative procedural errors and its consequences are essentials to avoid future problems to the tooth health.

Resumo Erros de procedimentos operatórios devem ser bem analisados e evitados em função de influenciar negativamente o prognóstico do tratamento do canal radicular. Tratamento do canal radicular bem sucedido previne a perda do dente, evita dor pulpar e lesão periapical. Esta revisão objetiva categorizar erros de procedimentos operatórios comuns e os fatores clínicos associados ao tratamento do canal radicular. Neste intuito, serão abordados os erros mais comuns e os fatores clínicos dentro da seguinte sequência operatória: planejamento do tratamento endodôntico, diagnóstico da doença pulpar e periapical, anestesia, preparo do acesso cavitário, isolamento do campo operatório, preparo do canal radicular, obturação e retratamento do canal radicular, restauração do dente tratado endodonticamente, dor pós-tratamento do canal radicular, e acompanhamento do dente tratado endodonticamente. O profissional deve estar consciente de que em cada fase operatória um erro pode ter implicação no prognóstico, e ser fator de risco ao fracasso. O conhecimento dos prováveis erros de procedimentos operatórios e suas consequências é essencial para evitar futuros problemas com a saúde do dente.

Operative Errors in Interlocking Intramedullary Nailing for Tibial Fractures / 대한정형외과학회잡지

From retrospective review of 111 tibial fractures treated by interlocking intramedullary nailing, 38 operative errors in 28 cases(25%) were included in this study. The errors were classified into two categories. The first category included eighteen errors that related to fracture reduction; nine angular malalignments, four failures in closed nailing to open the fracture site, two peroneal nerve palsies, two shortenings of tibial length(more than 1cm), and one rotational malalignment. The second category comprised twenty errors that related to the nailing itself; eight protrusions of proximal nail tip, five overdistractions of fracture gap (more than 3mm), four additional fragmentations, two mistakes in interlocking screw insertion, and one ankle joint injury by the distal nail tip. Functional results of those 28 cases at the last follow-up(average, 17.5 months; range, 9 to 29 months) were excellent or good in only 60.8 per cent, while the control group treated by adequate operative technique showed excellent or good results in 92.8 per cent.