Root Canal Retreatment

In rare cases, root canal therapy may not fully resolve the issue. The treated tooth might not heal as expected, or post-surgical complications may compromise its health. Root canal retreatment involves removing the previous crown and packing material, thoroughly cleansing the root canals, and then re-packing and re-crowning the tooth. Essentially, it mirrors the original procedure, with the added step of removing the prior restoration. The success rate for root canal retreatment is approximately 75%.

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Retreatment is often a better alternative than tooth extraction. If the tooth has good bone support, a solid structure, and healthy gums, it has a strong chance of being saved. Retreatment is also generally more cost-effective than alternatives like dental implants, extensive bridgework, or prosthetic teeth, which require maintenance and feel less natural than a real tooth.

Why Root Canal Retreatment May Be Required

Though additional endodontic work may seem daunting, root canal retreatment is typically completed in 1–3 visits. Reasons for retreatment include:

  • Cracked crown causing leakage of filling material
  • Curved or narrow canals not fully treated initially
  • Delay in placement of restorative devices after the original procedure
  • New decay in the treated tooth
  • New fracture in the tooth
  • Saliva entering the restorative structure
  • Undetected complex canal structures

What Root Canal Retreatment Involves

On the day of retreatment, a local anesthetic is administered unless another type has been selected. The affected tooth is isolated with a rubber dam to protect it from bacteria and saliva during the procedure. The scope of treatment in a single appointment depends on the level of inflammation and complexity of the case.

  1. Accessing the Tooth: If a crown and post are present, they are removed to access the inner tooth.
  2. Removal of Filling Material and Obstructions: An ultrasonic handpiece loosens old filling material. Tiny instruments are then used to clean and reshape the root canals. X-rays may be taken to confirm thorough cleaning. If complex, medicated packing may be applied and the procedure completed in a follow-up visit.
  3. Sealing the Canals: Once clean, gutta-percha, a rubbery material, is used to fill and seal the canals to prevent bacterial invasion.
  4. Restoration: A temporary crown or filling is placed initially. Later, a permanent, color-matched crown is applied.

If you have questions or concerns about root canal retreatment, please contact your dentist.