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Endodontic malpractice in DK Bj¢rndal & Reit
frequent (14.5%) in the 1995-1999 period and the
second most frequent (13.1 %) in the 2000-2004
period.
Endodontic claims
In 50% of the 482 analysed endodontic cases the
complaint were only limited to an endodontic problem,
while the rest showed a combination of one or more
fnrther dental problems (data not shown). The 482
endodontic claims were most often classified as due to
technical complications or incorrect treatment (28.4%)
(Table 3). Table 4 displays a further elaboration of
these 13 7 cases. In the 'technical complication' group
problems related to the root filling quality predominated
and in the 'incorrect treatment' group symptoms
Table 3 Endodontic complaints and the DCB decisions 1995-2002
Technical complications 55
or incorrect treatment
Other reasons 56
Persistent pain 24
Wrong treatment 11
Lack of information 11
Prolonged treatment 10
No data 12
Total 179
DCB decisions
Verdict of
malpractice
No verdict of
malpractice
74
26
39
37
10
6
21
213
of persisting infection were the most common. In 108
cases (22.4%) an endodontic sub-categorization was
not possible.
When the root filling quality was judged not to be
optimal the dentist most often was found guilty of
malpractice (Table 4). However, if the dentist had
explained why it was not possible to reach the very
best technical result, for example due to difficult root
canal anatomy, he or she was not found guilty of
malpractice.
Multi-rooted teeth were involved in 12 of 16 claims
concerned with fractured instruments. The DCBs considered
the dentist as guilty of malpractice if the canal
anatomy was simple, the root filling around the
instrument was defective, apical pathology was persistent
or the patient was not informed. Some DCBs stated
Settlement
2
69
80
Rejection
Table 4 Sub-categorization of 'technical complications' and 'incorrect treatments' and the DCB decisions (1995-2002)
DCB decisions
Verdict of
malpractice
No verdict of
malpractice
6
10
Total n 1%1
137 (28.4)
86 117.8)
64 (13.3)
50 (10.4)
21 (4.4)
16 (3.3)
108 122.4)
482 1100)
Settlement Rejection Total n 1%1
that an inst
well as a C(
malpractice
absence of 1
A signifk
in malprac
assigned to
tice freque1
treatment' g
Age and
exert influc
dentists W(
endodontic1
differed (P
proportion 1
contrast, tt
(71.0%,
(P < 0.000
tion of fem1
root canal
(Bj0rndal &
female corr
cantly low1
the male c
more, the
in an endc
significant!]
(53.0 ± 8.:
patients me
vided by olc
The frequer
a malpracti
in the male
borderline 1
ger female J
about older
Technical complications
Defective root filling (short, long, leaking,
not all root canals root filled)
Separated instrument
Root perforation (following instrumentation
or post-preparation)
Medicament related (all events after use of
a paraform- aldehyde product)
Other complications (e.g. a foreign body in
maxillary sinus, nerve damage)
Incorrect treatment
Symptoms of infection
Tooth was weakened/fractured/extracted
Treatment related persistent pain
Incorrect treatment is stated but not further
detailed
Total
31
55
11
10
10
18
10
12
2
74
44132.1)
16 (11.7)
9 (6.6)
4 (2.9)
12 (8.8)
23 (16.8)
12 (8.8)
14110.2)
3 (2.2)
3 137 (100.1)
Discuss ii
The preser
claims reg
2004. How
material su
but only th
NDCB. The
interpretati
sometimes
the results '
with a sett]
detailed inl
(11 = 374)
International Endodontic Journal, 41, 1059-1065, 2008
© 2008 International Endodontic Journal
© 2008 lnterna