Evaluating the Causes of Root Canal Treatment Failure in Southern Punjab, Pakistan

Background Numerous significant factors have been associated with root canal failure. Notably, the presence of bacteria within the root canal system constitutes a primary causative factor for the failure of root canal treatment. Objective: The objective of this study is to determine the most common cause of root canal failure in the public and private sectors of South Punjab, Pakistan. Materials and Methods: This cross-sectional study was carried out at the Endodontic Department of Multan Medical and Dental College in Pakistan from October 2022 to April 2023, examined 104 teeth with failed root canal treatments from patients seeking retreatment, and divided them into public and private sector treated groups to identify the main cause of failure through clinical and radiographic examination. Results Among 104 participants, 65.3% (n=68) were identified as male, whereas 34.6% (n=36) were identified as female. The primary cause of root canal failure among patients treated in the public sector was identified as broken instruments, accounting for 6.7% of cases. Conversely, patients treated in the private sector experienced root canal failure primarily due to poor coronal seal, which accounted for 23.0% of cases. Pain is the predominant manifestation of root canal failure, with a prevalence rate of 70%. Conclusion The mandibular first molar had the greatest endodontic treatment failure rate. Poor coronal seal and under-filled root canal caused most root canal failures. These events were more common in male patients and private sector hospitals than in public ones.