Endodontics

A previously treated tooth may develop persistent or recurrent disease for several reasons, including untreated canal anatomy, new decay, leakage from a restoration, fracture, or other problems affecting the treated tooth. The review may compare earlier and later radiographs, treatment notes, canal anatomy, restorations, symptoms, and retreatment records to determine what the evidence shows about the source and progression of the problem.

Cracks can affect teeth differently depending on their location and extent. A crack that reaches the pulp may lead to endodontic treatment, while deeper fractures extending below the gum line or vertical root fractures can substantially affect whether the tooth can be preserved. An endodontic expert can examine clinical findings, imaging, probing information, symptoms, and treatment records when crack diagnosis or management is disputed.

Endodontic surgery may be considered when nonsurgical treatment does not adequately resolve disease or when problems such as persistent infection, difficult canal anatomy, damaged root surfaces, or other conditions require access near the root end. An apicoectomy, or root-end resection, involves removing diseased tissue near the root tip and a small portion of the root end. The expert review may address the indication, technique, imaging, postoperative findings, and alternatives documented in the record.