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Root Canal Retreatment


When primary root canal treatment fails, root canal retreatment can be an essential dental procedure if the tooth is to be saved.

The subsequent paragraphs will endeavour to unmask the multiple facets of endodontic retreatment, providing you with the knowledge required for an informed discussion with your dental healthcare professional.

Why do I need an Endodontic Retreatment.

Endodontic retreatment is a necessary dental procedure when the primary endodontic treatment fails for various reasons. Common signs of failure include: pain, swelling around the tooth, increasing periapical periodontitis (noticed on x-ray) and tenderness to bite. The common reasons for failure of the primary treatment include: inadequate chemomechanical debridement of the root canal (because it was too complex), missed root canal (because of the complicated root canal system), fractured root and poor quality primary root canal filling.

In such cases, non-surgical endodontic retreatment is often the preferred approach, which involves:

  • Identifying the correct cause of failure.
  • Cleaning and disinfecting the root canal system (over 2 visits).
  • Properly sealing the root canal system.
  • Providing an optimal coronal seal.

In these cases we would strongly recommend that they are exclusively carried out by specialist endodontists.

While all endodontists are dentists, less than three percent of dentists are endodontists.

American Association of Endodontists

What Happens During Endodontic Retreatment.

Endodontic retreatment is typically performed over two visits. The first step involves the removal of the root canal filling materials. The tooth is then meticulously examined for any new infections, fractures, blockages or additional canals and is very similar to primary endodontic treatment.

Infections, if any, are removed, and the canals are cleaned and shaped. After the cleaning process, new root canal filling materials are placed and the tooth is temporarily filled. This is done to prevent any new infections from entering the tooth while it heals.

Steps Description
Anaesthesia Local anaesthesia is administered to ensure a painless procedure
Infection Removal Infections are removed, and the canals are cleaned and shaped
New Filling New restorative materials are placed, and the tooth is temporarily filled
Restoration Once healed, a new crown or restoration is placed on the tooth

Endodontic retreatment concludes with the placement of a new restorative material (crown) to protect the tooth. Regular follow-up visits are necessary to monitor the healing process and ensure the long-term success of the retreatment.

Is Endodontic Retreatment The Best Thing For Me?

Endodontic retreatment might be the best thing for you if you want to preserve your natural tooth and avoid extraction. With the aid of modern dental equipment and techniques and a highly trained specialist endodontist, retreatment can effectively resolve the issue causing the initial treatment’s failure.

Retreated teeth can function well for years, even for a lifetime. The success rate of endodontic retreatment is high, and it’s important to note that your endodontist will discuss the probability of success before commencing the procedure. The use of advanced technology, such as antibacterial paste, can reduce bacterial growth and improve healing chances, contributing to the long-term success of the procedure.

However, retreatment is typically more expensive than the initial treatment, with costs varying based on the complexity of the procedure. Despite the cost, the potential to save your natural tooth and maintain its functionality over time might make endodontic retreatment the best thing for you.

What Are The Alternatives to Endodontic Retreatment?

Several alternatives can be considered when endodontic retreatment is not feasible or desired. They include periradicular surgery OR extraction of the tooth and replacement. The choice will depend on the patient’s unique circumstances and overall oral health.

Periradicular surgery is a viable alternative to endodontic retreatment. This surgical procedure allows endodontists to locate small fractures or hidden canals that weren’t detected during initial treatments.

Alternatively, the patient may opt for tooth extraction. This procedure is often followed by replacing the extracted tooth with an implant, bridge, or removable partial denture.

However, it’s important to note that these alternatives to retreatment can be more costly and time-consuming than endodontic retreatment itself. Therefore, the decision should be made in consultation with a dental professional.

Alternative Description Considerations
Periradicular Surgery Locates small fractures or hidden canals. Can be more invasive than retreatment.
Tooth Extraction Complete removal of the tooth. Costly; requires tooth replacement.
Implants, Bridges, or Dentures Replace the extracted tooth. Time-consuming and expensive.


Root Canal Retreatment FAQ

Is a Root Canal Retreatment Painful?


Contrary to common perception, a endodontic retreatment is generally not painful. This is due to the use of local anaesthesia to numb the area. Any post-procedure discomfort can usually be managed with over-the-counter pain relievers.

Is Endodontic Retreatment Worth It?


Endodontic retreatment is generally considered worthwhile. It preserves the natural tooth, potentially offers improved technique benefits, and promotes a healthy, functioning tooth for extended periods. However, individual circumstances can impact the decision.

How Often Do Root Canals Need to Be Retreated?


The frequency of endodontic retreatment varies and is contingent on individual circumstances. Failure of the initial treatment, recurrent infection, or inflammation may necessitate retreatment. Regular dental check-ups can help monitor the tooth’s condition.

Do I Need a New Crown After Root Canal Retreatment?


After a endodontic retreatment, it may be necessary to have a new crown. It depends on the condition of the existing crown and the extent of the retreatment procedure. Consult your dentist for personalized advice.

What is root canal retreatment?


Endodontic retreatment is a procedure to treat a tooth that has previously undergone a root canal treatment but has become reinfected or is experiencing persistent symptoms.

How do I know if I need root canal retreatment?


You may need endodontic retreatment if you are experiencing severe pain, swelling, or sensitivity in a tooth that has already had a root canal.

What are the reasons for needing root canal retreatment?


Reasons for needing endodontic retreatment may include incomplete cleaning of the root canal system during the initial treatment, new decay or damage to the tooth, or a defective crown or restoration.

Can any tooth undergo root canal retreatment?


Most teeth, including molars, can undergo endodontic retreatment if it is deemed necessary by your endodontist or general dentist.

How is a endodontic retreatment performed?


The retreatment involves gaining access to the root canal, removing the previous filling material, cleaning the canal, and then filling and sealing it again to prevent future infection.

What are the next steps after endodontic retreatment?


Following endodontic retreatment, your tooth may require a new crown or other restoration to protect and restore it to full function.

Can I get endodontic retreatment from my general dentist?


In most cases, endodontic retreatment is performed by an endodontist, who is a specialist in treating infected teeth and performing root canal procedures, but some general dentists may also offer this service.

Is endodontic retreatment covered by insurance/NHS?


Root canal retreatment is often covered by dental insurance, and some national healthcare systems, like the NHS, also provide coverage for this procedure.

What are the success rates of endodontic retreatment?


The success rates of endodontic retreatment are generally high, with a reported success rate of approximately 75-85% for cases needing retreatment.

How can I prevent the need for root canal retreatment?


Good oral hygiene and regular dental check-ups can help prevent the need for root canal retreatment by ensuring that any dental issues are identified and treated before they escalate to the need for retreatment.

What is the success rate of Endodontic Surgery


The success rate of endodontic surgery, also known as apical surgery or root-end surgery, can vary depending on various factors such as the specific case, the skill and experience of the endodontist, and the condition of the tooth. However, on average, endodontic surgery has a success rate of approximately 85-95%.

It is important to note that the success of endodontic surgery also depends on the patient’s oral hygiene habits and their commitment to post-operative care. Following proper oral hygiene practices and regular dental check-ups can significantly enhance the chances of a successful outcome.



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