Root Canal Retreatment

Most root canals that are performed are successful. In rare cases, root canal therapy fails to work as expected. The treated tooth may not heal properly or a patient might experience post-surgical complications that jeopardize the tooth. A root canal retreatment is necessary in such instances. Root canal retreatment involves the removal of the previous crown and packing material, the cleansing of the root canals, and the re-packing and re-crowning of the tooth. In short, root canal retreatment is mostly identical to the original procedure aside from the structural removal. The success rate for a root canal retreatment is as high as 75%.

Root canal treatments and retreatments are a better than the alternative of extraction for most individuals. If a tooth has good bone support, a solid surface with healthy gums beneath it, it stands a good chance of being saved.  A patient who opts for root canal retreatment is choosing the most cost-efficient procedure. The alternatives to root canal retreatment include: dental implants, extensive bridgework, and the creation of prosthetic teeth, all of which cost far more than working with the natural tooth. These treatments require more maintenance as well as feel less natural than a “real” tooth.

Why is root canal retreatment required?

An endodontic surgery that has to be repeated is hardly pleasant news but the fact is that root canal retreatment is fairly simple. In general, the whole treatment can be completed in 1-3 visits.

There are a number of reasons why root canal therapy unexpectedly fails, including:

• Cracked crown leaking filling material.
• Curved or narrow canals not treated during the original procedure.
• Delay in the placement of restorative devices following the procedure.
• New decay to the tooth.
• New fracture in the treated tooth.
• Saliva entering the restorative structure.
• Undetected complex canal structures.

What does root canal retreatment involve?

On the day of the retreatment procedure, a local anesthetic will be administered unless another type of anesthetic has been selected. The affected tooth is isolated with a rubber dam. The dam protects the tooth during treatment from bacteria and saliva. How much the dentist can work on in a single appointment will depend on the amount of inflammation present and the complexity of the treatment.

The first step in a root canal retreatment is to gain access to the inner tooth. If a crown and post have been placed, these will be removed.

Next, filling material and obstructions that block the root canals will be removed. This removal is done using an ultrasonic handpiece. The advantage of using this tool is that any unwanted material is vibrated loose.  The dentist will then use tiny instruments to clean and reshape the root canals. The dentist will ensure that the roots are thoroughly cleaned through X-ray imaging. If this part of the treatment proves to be complex medicated packing material will be applied. This complication delays the rest of the cleansing procedure to the next visit.

When the dentist is confident that the root canals are completely clean he uses gutta-percha to pack the space. This rubbery material seals the canals to prevent bacterial invasion. As the last step, a temporary crown or filling is applied to tooth. At a later date, the color-matched permanent crown will be placed.

If you have any questions or concerns about root canal retreatment, please call Dr. Levin’s office.