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drmithila
Outcomes/Evaluation
The evaluation of Phase III therapy should include the final evaluation of endodontic therapy success or failure. First, if the tooth displays complete healing following a 6-month recall period with full radiographic resolution of the lesion, with a normal PDL space, asymptomatic, and no associated pathology, then the case can be considered a success. Second, if the tooth presents with a radiographic lesion that is decreasing in size, asymptomatic, functional with no associated pathology then the treatment is in the process of healing and the recall period should be lengthened to one to 4 years and be re-examined for complete healing. Third, if the patient is asymptomatic and the lesion appears smaller but persistent over a lengthened period of time, a scar formation may be considered and the therapy a success. Fourth, if following an appropriate recall period the tooth presents with a lesion that is increasing or the same size, the patient has become symptomatic, or has developed swelling, or a sinus tract, then apical resurgery or extraction should be recommended.
Following this exhaustive process of providing all therapy accessible prior to determining the tooth inoperable, the therapy should now be considered unsuccessful. Each phase of endodontic therapy addressed its specific goals, and if the tooth remains symptomatic or demonstrates increased bony destruction, then the therapy should be considered a failure and an alternative prosthetic replacement should be considered.
SUMMARY
This paper has shown that modern endodontics has progressed significantly in describing and treating pulpal and periradicular pathology. Current knowledge indicates that endodontic therapy should be evaluated as a complete unit and that each phase of treatment is completed to provide a foundation for rehabilitation. The phase format assessment of endodontic therapy success provides an outline for clinicians to objectively provide treatment in effort to conserve natural dentition.