Microscopic management of procedural errors.

Abstract

This article provides the clinician with several methods of dealing with furcation and post perforation as well as separated instruments. The endodontist must first understand how to eliminate procedural accidents that can occur, then, accurately and predictably treat those teeth to which accidents have occurred. Techniques to repair furcation and post perforations and retrieval of fractured root canal instruments are presented. An in-depth description of each technique has been included. Lastly, clinicians must be cognizant of limitations in treating these difficult problems that will arise in dental practice. Active patient participation and communication must be maintained during the scope of treatment to provide patients with the highest quality of endodontic service possible. A challenging variety of problems present to even the most skilled dental practitioner over time. The ability to diagnose and treat these difficult conditions relies heavily on the ability to envision adequately the source of the problem. In the past, operating loupes and headlamps were the most effective option afforded to practitioners as a solution to magnification and illumination. Not only were these devices cumbersome to use, but also the dentist was limited to performing the entire procedure under one level of magnification. The advantages of using the microscope in the correction of procedural errors enhances the operator's ability to perform each step in a procedure with a heightened sense of knowledge. The practitioner is cognizant of the exact details of an iatrogenic development because he or she has visualized the area in great detail. The reconstruction of the tooth or removal of instruments can be carried out with confidence because the dentist has more control of the working environment than ever before. New restorative materials and instruments are available so deliberate precision can be implemented with the microscope's ability to illuminate and magnify the working field. In time, these improvements in technology and techniques will result in greater confidence and success in the prevention and treatment of procedural errors.