Endodontist Questions Endodontic Retreatment

What does endodontic retreatment involve?

I recently read about an endodontic re-treatment procedure after my mom is scheduled to get it done. What does this treatment involve?

13 Answers

An endodontic re-treatment is indicated when there is an existing root canal that is failing either clinically with symptoms or radiographically showing a radiolucency that appears to be increasing in size. Re-treatment cases must be thoroughly evaluated and a 3-D cone beam X-ray would be indicated to look for reasons for possible failure prior to commencing with treatment. A clinician would want to look for evidence of inadequate instrumentation and root canal sealing "obturation." In addition to any missed canals or leakage at the crown margins or restoration failure. One final concern is the possible presence of a crack or fracture. Cracks and fractures leaves a hopeless prognosis. Once it is decided that re-treatment is a good option, then the tooth must be accessed and all previous root canal filling material must be removed and any missed canals located. Then the canals will need to be thoroughly cleansed and disinfected with the proper medicaments all the way to the apex of the roots. Then completely sealed all the way to this point also. Finally, a PROPER and complete restoration of the crown of the tooth must be completed with NO POSSIBILITY of leakage for the BEST possible prognosis.
Best of luck with your chosen treatment.

Paul Northup, DDS
Essentially the same as initial nonsurgical root canal treatment from the patient perspective. Technically, it is more difficult for the endodontist because the prior treatment materials have to be removed and any procedural problems must be corrected/repaired. To reflect this additional challenge, the duration of time for retreatment is frequently longer than initial root canal treatment.
A retreatment is basically going into the tooth, removing all existing material that was placed prior, and recleaning canals out. Sometimes additional canals are treated if present.
Taking out the old root canal material, if possible, just depends on the previous material used (sliver points are hard to remove) then clean out the canals and take new measurements of the each canal and fill with gutta percha. If no infection and if it's infected, clean out the canal, fill with medication, and you would come back in 2-4 weeks while on antibiotic and finally complete RC.
If you got to the aae.org website, you will find detailed explanation of the procedure with a video
Endodontic re-treatment basically is doing root canal all over again when it's failing. You won't feel any difference though, but it may take longer and multiple visits.
ENDODONTIC RETREATMENT


With the appropriate care, your teeth that have had endodontic treatment will last as long as other natural teeth. Yet, a tooth that has received treatment may fail to heal or pain may continue to exist. Sometimes, the pain may occur months or years after treatment. If so, Endodontic Retreatment may be needed.


IMPROPER HEALING MAY BE CAUSED BY:

* Curved or narrow canals that were not treated during the initial treatment.
* Complicated canals that went undetected during the initial treatment.
* The crown or restoration was not placed within the appropriate amount of time following the procedure.
* The crown or restoration that did not prevent saliva from contaminating the inside of the tooth.


IN SOME CASES, NEW PROBLEMS CAN INFLUENCE A TOOTH THAT WAS SUCCESSFULLY TREATED:

* New decay can expose a root canal filling material, causing infection.
* A cracked or loose filling or crown can expose the tooth to new infection.
It means an old root canal has a problem and it needs to be redone.
An endodontic retreatment is done on a tooth that already has a previous root canal. First, your mom will be anesthesized locally, a rubber dam will be placed over her tooth, then the old filling material will be removed, the canal re-cleansed and shaped, and refilled. This procedure should be done only by an endodontist.
A non-surgical retreatment involves the removal of the previous root canal filling materials and a thorough disinfection of the root canal system. In addition the tooth will be fully assessed for any canals that may have been missed in the initial treatment, and also examined for cracks and decay. The procedure is similar to an initial root canal treatment in that it is non-surgical, however it is typically more difficult and requires more time.
This involves redoing the original root canal in an effort to clean again or potentially revise the previous treatment. The original root canal filling materials will be removed and the inside of the tooth will be disinfected. The root canals are then re-filled. Retreatment can be very effective in getting the tooth back to health.
It is essentially an endodontist (root canal specialist) re-doing the original root canal treatment. Usually done with a microscope for improved vision, the endodontist removed the post (if present) and removes the root canal fillings, basically undoing everything that was done originally. The endodontist would look for missed canals, fractures and whatever else would have caused the original treatment to fail. Retreatment is not easy, the canals are filled with a "permanent" filling which means that it is not easy to remove. It may often take several visits, and in extreme cases, sometimes the endodontist will recommend surgery if required. Surgery is never a first choice (at least in endodontic offices). Retreatment usually has a higher success rate than endodontic surgery, which is why it is recommended as a first choice.
Everything dentist do will eventually fail!! Root canals tend to fail for one of three reasons. 1. something cracks or breaks, 2, something is left behind and festers an infection. 2. Something leaks back in and reinfects the root canal system. Reinfection is the #1 reason for failures. A retreatment involves removing the old root canal filling, redisinfecting the tooth, then putting a new root canal filling in. They have a high degree of success. While much harder for the dentist, it usually is easer for the patient since there is no nerve in the tooth.