From the Research
The success rate of over-extended gutta percha in root canal treatments is generally good, with a success rate of 71% to 87% reported in recent studies, such as the systematic review and meta-analysis by 1. The prognosis depends on several factors including the extent of overfill, presence of pre-existing periapical lesions, and quality of the overall root canal treatment. Some key points to consider are:
- Small overfills (1-2mm) typically have minimal impact on outcomes, while larger extrusions may cause temporary post-operative pain or inflammation.
- The body can usually tolerate gutta percha as it's biocompatible, with macrophages and giant cells gradually removing the material over time.
- Treatment is not typically required for asymptomatic overfills, but persistent pain or infection may necessitate surgical intervention such as apicoectomy.
- The most important factor affecting prognosis is the thoroughness of canal cleaning and disinfection rather than the overfill itself, as highlighted by studies such as 2 and 1.
- Patients should be informed about the overfill, monitored with follow-up radiographs at 6-12 month intervals, and reassured that most cases resolve without intervention as the body's immune system manages the extruded material.
- Nonsurgical management of overextended gutta-percha, as described in studies like 3, can be an effective approach in some cases, and may involve the use of aspiration, triple antibiotic paste, and calcium hydroxide to promote healing and osseous regeneration.
- It is also worth noting that the presence of a periapical radiolucency, periapical lesions >5mm, a higher initial PAI score, multiple-visit retreatments, and mandibular and molar teeth can result in a lower success rate, as reported by 1.