Adverse Events and Malpractice Claims in Endodontics

Adverse Events and Malpractice Claims in Endodontics

Main Article Content

Gabriel Fonseca
Karina Mira
Héctor Beltrán
Katherine Peña
Violeta Yendreka


An "adverse event" has defined as a non-intentional complication result of health care treatment, and although it can have different causes, always involves the providing care, but not the complications inherent to the patient’s disease itself. Adverse events, iatrogenic complications and malpractice have been clearly differentiated because only malpractice causes liability: while iatrogenic events can be result of a well-performed procedure, malpractice involves damage caused by negligence or lack of knowledge, and it is a potential for complaint and liability claim. In dentistry, endodontics is one of the specialties of greatest challenge where adverse events and malpractice claims have been reported with significant frequency. We present a literature review searching the main causes and results of malpractice claims in endodontics. Three articles from Italy, Israel and Denmark were selected, where the most claimed adverse events were root perforations, inappropriate drug therapies, defective root fillings and instrument fracture. One of the articles referred to malpractice verdicts in 97.5 % of claims. Since endodontics leads dental malpractice claims in Chile, strategies of risk management for these procedures are discussed; the adherence to strict protocols is proposed and measures to minimize the negative effects of these events are recommended.


Bjørndal, L. & Reit, C. Endodontic malpractice claims in Denmark 1995-2004. Int. Endod. J., 41(12):1059-65, 2008.

Cohen, S. & Schwartz, S. Endodontic complications and the law. J. Endod., 13(4):191-7, 1987.

Chomali, G. M. & Miranda, S. F. Gestión de riesgos en la atención de salud: hacia una cultura de la calidad basada en la seguridad. Rev. Clin. Las Condes, 14(4), 2003. Disponible en: http://

García, F. M.; García, G. A. & García, F. M. Iatrogenia y dyspraxis médica: Un enfoque bioético. R. F. M., 28(1):6-11, 2005.

Givol, N.; Rosen, E.; Bjørndal, L.; Taschieri, S.; Ofec, R. & Tsesis, I. Medico-legal aspects of altered sensation following endodontic treatment: a retrospective case series. Oral Surg. Oral Med. Oral Pathol. Oral Radiol. Endod., 112(1):126-31,2011.

Givol, N.; Rosen, E.; Taicher, S. & Tsesis, I. Risk management in endodontics. J. Endod., 36(6):982-4, 2010.

Kraemer, P. & Vera, L. A. Revisión de estrategias efectivas para la seguridad de la atención del paciente. Santiago de Chile, Ediciones Ministerio de Salud de Chile, 2008.

Lin, L. M.; Rosenberg, P. A. & Lin, J. Do procedural errors cause endodontic treatment failure? J. Am Dent. Assoc., 136(2):187-93, 2005.

Morales, A. Gestión del riesgo en un Servicio de Radiología. Todo Hosp., 237: 349-65, 2007.

Perea-Pérez, B.; Labajo-González, E.; Santiago-Sáez, A.; Albarrán-Juan, E. & Villa-Vigil, A. Analysis of 415 adverse events in dental practice in Spain from 2000 to 2010. Med. Oral Patol. Oral Cir. Bucal, 19(5):e500-5, 2014.

Perea-Pérez, B.; Santiago-Sáez, A.; García-Marín, F.; Labajo-González, E. & Villa-Vigil, A. Patient safety in dentistry: dental care risk management plan. Med. Oral Patol. Oral Cir. Bucal, 16(6):e805-9, 2011.

Pinchi, V.; Pradella, F.; Gasparetto, L. & Norelli, G. A. Trends in endodontic claims in Italy. Int. Dent. J., 63(1):43-8, 2013.

Pineda Mejía, M. E. Retratamiento no quirúrgico de fracasos endodónticos: Parte - I. Odontol. Sanmarquina, 6(11):35-40, 2003.

Portela, L. F. J. Caracterización de los aspectos bioéticos en los reclamos realizados ante la Superintendencia de Salud de Chile en el área de odontología. Acta Bioet., 19(1):143-52, 2013.

Rosen, E.; Tsesis, I.; Tamse, A.; Bjørndal, L.; Taschieri, S. & Givol, N. Medico-legal aspects of vertical root fractures in root filled teeth. Int. Endod. J., 45(1):7-11, 2012.

Selbst, A. G. Understanding informed consent and its relationship to the incidence of adverse treatment events in conventional endodontic therapy. J. Endod., 16(8):387-90, 1990.

Silva, R. F.; Martins, E. C.; Prado, F. B.; Júnior, J. R. & Júnior, E. D. Endoscopic removal of an endodontic file accidentally swallowed: clinical and legal approaches. Aust. Endod. J., 37(2):76-8, 2011.

Webber, J. Risk management in clinical practice. Part 4. Endodontics. Br. Dent. J., 209(4):161-70, 2010.