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Endodontic Retreatment / Root canal Retreatment

Although endodontic treatment has very high sucess rates, there are cases in which reintervention is deemed necessary and the treatment is repeated.

Why does a root canal re-treatment /reintervention may be deemed necessary?

Endodontic re-treatment is necessary when the initial treatment was not completely successful or when new problems arise within a previously treated tooth. Some common reasons include:

  1. Incomplete cleaning of the root system during the initial treatment: In some cases, the dentist may not have completely removed all the infected tissue during the initial endodontic treatment, leaving behind a potential source of re-infection.

  2. Failure to find and treat an entire root canal: The complex anatomy of teeth can result in additional root canals not being detected during initial treatment. These pipes remain contaminated and can cause a multitude of problems.

  3. Micropenetration around the worn margins of an old restoration or loss of the entire restoration: The material with which a tooth is filled can wear down over time, allowing bacteria to re-enter and cause reinfection.

  4. Trauma or Caries: Even if a tooth has received a successful endodontic treatment, it may be vulnerable to re-injury or caries, re-infection causing the need for re-intervention

When a root canal re-treatment is necessary?

Re-treatment is usually recommended when one or more of the following conditions are met:

  1. Persistence or Recurrence of Pain: If pain or discomfort persists or returns after the initial endodontic treatment is completed, retreatment may be indicated.

  2. Abscess/swelling: The presence of an abscess or signs of infection in the soft tissues surrounding a previously treated tooth may indicate reinfection or inadequate initial treatment.

  3. Presence of Radiographic Evidence: Radiographs can reveal bony lesions that persist,  or initial endodontic treatments that have not been satisfactorily completed.

  4. Possible re-infection of a treated tooth due to wear or fracture of an old restoration or prosthetic work: Before placing a new prosthetic work (case, bridge, etc.) we must be sure of the health of the root of the tooth that will support it.

Alternative treatment options

While repeating an endodontic treatment is a common approach to saving a previously treated tooth, alternative treatments can also be considered:

  1. Extraction of the Tooth: In cases where re-intervention is not possible or unsuccessful, extraction of the tooth may be recommended, followed by the application of a dental implant or bridge.

  2. Apicectomy: This surgical procedure involves the removal of the tip of the tooth root and can be applied as an alternative to repeat endodontic treatment.

  3. Simple monitoring: In some cases, if the tooth is asymptomatic and there are minimal signs of infection, a dentist may choose to monitor the situation very closely rather than proceed with immediate reoperation.

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