Root Canal Retreatment

In some rare instances, root canal therapy may not yield the expected results. The treated tooth may not heal properly, or complications may arise post-surgery, putting the tooth at risk. Root canal retreatment becomes necessary in such cases, involving the removal of the previous crown and packing material, cleansing of the root canals, and re-packing and re-crowning of the tooth. Essentially, root canal retreatment is similar to the initial procedure, with the exception of structural removal. The success rate for root canal retreatment is approximately 75%.

For most individuals, root canal treatments and retreatments present a better alternative to tooth extraction. If a tooth has good bone support, a solid surface, and healthy gums, there is a good chance of saving it. Opting for root canal retreatment is often more cost-effective compared to alternatives such as dental implants, extensive bridgework, or prosthetic teeth. These alternatives not only incur higher costs but also require ongoing maintenance and feel less natural than a preserved natural tooth.

Why is root canal retreatment necessary?

While the idea of additional endodontic treatment may not be appealing, root canal retreatment is a relatively straightforward procedure. Typically, the entire treatment can be completed in 1-3 visits.

Several factors can contribute to the unexpected failure of root canal therapy, including:

1. Cracked crown leaking filling material.
2. Untreated curved or narrow canals during the initial procedure.
3. Delay in placing restorative devices after the initial treatment.
4. New decay or fracture in the treated tooth.
5. Saliva entering the restored structure.
6. Undetected complex canal structures.

What does root canal retreatment involve?

On the day of the retreatment procedure, a local anesthetic will be administered, unless an alternative anesthetic option has been selected. To protect the tooth during treatment from bacteria and saliva, a rubber dam is placed to isolate the affected tooth. The complexity of the treatment and the level of inflammation will determine the extent of what can be done in a single appointment.

The first step in root canal retreatment is accessing the inner portion of the tooth. If a crown and post were previously placed, they will be removed.

Next, the filling material and any obstructions blocking the root canals are removed using an ultrasonic handpiece. This tool effectively vibrates loose any unwanted material. Small instruments are then used to thoroughly clean and reshape the root canals. X-rays may be taken to ensure complete cleanliness of the roots. If this part of the treatment proves complex, medicated packing material may be applied, and the rest of the cleansing procedure will be completed during the next visit.

Once the dentist is confident that the root canals are thoroughly clean, gutta-percha, a rubbery material, is used to pack the space. This seals the canals, preventing bacterial invasion. Finally, a temporary crown or filling is placed on the tooth. At a later appointment, a permanent crown matching the tooth color will be placed.

If you have any questions or concerns about root canal retreatment, it is best to consult with your dentist. They can address your specific needs, discuss the procedure in detail, and provide guidance to ensure the best possible outcome.

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