🦷 Top 10 Mistakes in Root Canal Treatment (RCT) & Prevention

1. ❌ Incorrect Diagnosis

• Mistake: Treating wrong tooth / misdiagnosing pulpal condition
• Avoid:
  • Thorough history + clinical tests (thermal, percussion)
  • Use radiographs (multiple angles)

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2. ❌ Poor Access Cavity Preparation

• Mistake: Inadequate or overextended access
• Effect: Missed canals / perforation
• Avoid:
  • Follow proper tooth anatomy
  • Ensure straight-line access

    3. ❌ Missing Canals

  • Mistake: Not locating all canals (e.g., MB2 in maxillary molars)
  • Avoid:
    • Careful exploration
    • Use magnification (loupes/microscope)
      
      
      

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  4. ❌ Working Length Errors

• Mistake: Over- or under-estimation of canal length
• Effect: Underfilling or overfilling
• Avoid:
  • Use apex locator + confirm with radiograph
  • Recheck during procedure

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5. ❌ Instrument Separation

• Mistake: File breakage inside canal
• Causes: Excess force, reuse of files
• Avoid:
  • Use gentle motion
  • Follow recommended usage of instruments
  • Create glide path
    
    
    

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6. ❌ Canal Transportation / Ledge Formation

• Mistake: Deviating from original canal path
• Avoid:
  • Use flexible NiTi files
  • Maintain glide path
  • Avoid excessive force

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7. ❌ Inadequate Cleaning & Shaping

• Mistake: Leaving infected tissue/debris
• Avoid:
  • Proper irrigation (e.g., sodium hypochlorite)
  • Adequate shaping techniques

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8. ❌ Poor Irrigation Protocol

• Mistake: Insufficient or improper irrigation
• Avoid:
  • Use copious irrigation
  • Activate irrigants (ultrasonic/manual)

    9. ❌ Improper Obturation

  • Mistake: Voids, underfilling, overfilling
  • Avoid:
    • Dry canal properly
    • Use correct obturation technique (lateral/vertical condensation)
    • Confirm with radiograph

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  10. ❌ Inadequate Coronal Seal

• Mistake: Poor temporary/permanent restoration
• Effect: Reinfection
• Avoid:
  • Place good quality restoration immediately
  • Ensure tight coronal seal

    🧠 Quick Revision Tip (Mnemonic)

    “D A M W I T C I O C”
    (Diagnosis, Access, Missing canals, Working length, Instruments, Transportation, Cleaning, Irrigation, Obturation, Coronal seal)

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