Does the extent of obturation affect the outcome of endodontics? #dentists #rootcanaltherapy

Añadido: 2026-05-22

[00:00:00]This patient was referred to me 6 months ago.

[00:00:03]Here's a date.

[00:00:06]And this is today's date.

[00:00:08]6 months ago for endodontic treatment of tooth number 14. According to the patient, her dentist had done a filling on the tooth a couple of weeks prior and ever since the filling tooth was basically hurting to everything. Hot, cold, biting, chewing on it. Spontaneous pain, pain that would wake her up in the middle of the night.

[00:00:28]She went and saw her dentist a couple of times.

[00:00:31]The uh occlusion was adjusted and what have you and this last time patient says that she went and saw her dentist, her dentist did a cold test and at first she didn't feel it, but then a few minutes later the pain started and it became excruciating. So, her dentist referred her to us to us to uh for a root canal and we found the tooth to be in the state of irreversible pulpitis to the point of uh basically partially partially necrosis even.

[00:00:59]So, we discuss options and patient could not live with her symptoms. So, she wanted to go ahead and get a root canal.

[00:01:05]This is one of those cases and my channel's my channel's one of those channels, my case is one of those cases that I post everything and I believe that you can learn from mistakes more so than from a perfect root canal. So, this is real world real life real world endodontics and you can benefit from um the mishaps sometimes unintentional.

[00:01:26]Uh you guys can learn and of course I can learn from them as well. So, you can see this tooth is heavily calcified.

[00:01:32]There's no pulp chamber associated with the tooth.

[00:01:34]Tooth number 15 also, tooth number 14.

[00:01:37]You can see that huge pulp stone in what used to be a pulp chamber, right?

[00:01:42]Same as tooth number 15. So, this tooth is definitely not an easy root canal.

[00:01:49]Okay? So, we went ahead and did the root canal, but look what happened. First off, for the life of me I couldn't locate the MB2. You can see the endo axis.

[00:01:58]Secondly, I trust my apex locator, right? And look, my apex locator told me that my working length was a certain working length and it wasn't. I was actually over instrumenting.

[00:02:14]I'm glad I'm in uh situations like that uh and and lately I've been keeping my as you can see my taper to the minimum and I rely heavily on my irrigation protocol. 6% sodium hypochlorite, sonic and ultrasonic activation.

[00:02:31]All right, but every single canal I had instrumented and obturated long.

[00:02:40]Didn't notice any bleeding. Didn't notice any sign signs that I was obturating long, but as you can see, look at the distal buccal.

[00:02:49]And there was an MB2 as you can see, right here.

[00:02:52]I trough for it, just could not catch it, but I was able to clean it, disinfect it through the MB1 canal as you can see.

[00:03:01]That's the tracing up there.

[00:03:04]Sealer right into the MB2 canal, which joins the MB1. But unfortunately, I over instrumented and therefore obturated every single canal long.

[00:03:24]Every single canal, look at the MB canal, MB1, look how long.

[00:03:30]Distal buccal, palatal is not too bad, but still.

[00:03:37]So, is this root canal going to fail because I accidentally and unintentionally instrumented and obturated it long?

[00:03:53]Here's the 6 months post-op of the tooth.

[00:03:56]And here's the date.

[00:03:59]I saw the patient yesterday. This is today's date.

[00:04:02]6-month post-op of the tooth. Tooth has a crown on it right now.

[00:04:07]Patient reports no symptoms whatsoever.

[00:04:12]Tooth responded within normal limits to percussion, palpation. Probings were all 1 2 2 2 3 mm.

[00:04:18]And look at the radiograph. That's one angulation. Again, you can see the long the long obturator.

[00:04:27]This is another angulation. No periapical radiolucencies. This root canal did not fail because I accidentally and unintentionally instrumented and obturated long.

[00:04:38]Remember Dr. Lin's famous study, the extent of obturation does not affect the outcome of endodontics. You can obturate short, obturate long, obturate flush.

[00:04:47]As long as you clean the canals so there are no bacteria within the root canal system the extent of obturation does not affect the outcome.

[00:05:00]And you can again you can see the MB2.

[00:05:03]But here's the 6-month follow-up of tooth number 14. Tooth is in full function.

[00:05:10]Patient has no symptoms whatsoever.

[00:05:13]And you can see the radiographs.

[00:05:15]No periapical radiolucencies. No issues whatsoever.

[00:05:26]And again, here's the date which was yesterday. This is today's date.

[00:05:32]6-month post-op of tooth number 14. Real world endodontics.

[00:05:37]Nothing to hide.

[00:05:39]Stuff like that happens even to an endodontist with 24 years of experience.

[00:05:45]But if you if we adhere to the fundamentals of endodontics and unintentionally and by mistake do something like this the endo gods can favor us and usually would and will favor us.

[00:06:13]Again, this was done unintentionally.

[00:06:17]Don't go now go around over instrument and over obturate canals now just because you saw it here.

[00:06:25]But what I'm saying is that once in a while if unintentionally by mistake something like this happened but the clinician has a key adhered and followed the fundamentals of endodontics it's very likely that everything will be fine.

[00:06:40]So 6 months post-op follow-up of tooth number 14 as I said patient reports no symptoms no issues whatsoever.

[00:06:51]As you can see tooth was built up has a brand new crown on it. It was within normal limits to percussion palpation probings were 1 2 3 millimeters all around and again you can see multiple angulation PAs show no periapical radiolucencies no issues whatsoever with this tooth.

[00:07:08]6 months follow-up of tooth number 14.