It is possible for some teeth that had root canal treatment to heal improperly, become painful or diseased after months or years. İf this happens, you have a second chance to save the tooth with retreatment. İt can also be done to teeth that has short root canal filling and that is going to be used as an abutment teeth for dental bridge procedure. Your dentist will decide if your teeth needs retreatment or not.
You can read the article about root canal therapy for further information about root canal procedure.
How the root canal retreatment is done?
Root canal therapy is done as usual root canal therapy, most of the steps are similar. Primary goal is to regain access to the periapical area.
Endodontic retreatment step by step :
– Dental X-ray is used to evaluate the status of your teeth and whether retreatment is indicated or not.
– Removal of the coronal restoration(filling, crown, core build-up material, post placed into the canal) is done with specially designed burs till the canal orifices filled with gutta percha are seen.
– Root canal filling(gutta percha) is removed with special root canal files. This step can be difficult. The patient will not feel pain during this step, but it will take time to remove the gutta percha and the patient must keep their mouth open during this procedure.
– Additional dental x-rays may be needed to evaluate whether all gutta percha filling has been removed or not. These x-rays will not cause harm to your body as they require very low levels of radiation exposure. But you should inform your dentist before dental x-rays if you are pregnant.
– Root canal medicaments are applied after the root canals are adequately shaped and cleaned by irrigation and temporary filling is placed. The medicament needs to stay in root canals for 1-2 weeks. During this time there may be some complications, do not panic if any pain, swelling occurs. Read our article about what we should do after root canal treatment.
– İn the next appointment(1-2 weeks after) your dentist may renew the root canal medicament if inflammation is not resolved yet or may obturate the root canal and restore the tooth. İf you want further information about what to do after root canal therapy you can read the article about root canal therapy.
Indications for root canal retreatment
- Tenderness to percussion or apical pain to pressure
- Short or overfilled root canal filling
- Tooth that has questionable root canal filling and will serve as an abutment for dental bridge
- Fistula formation or swelling of soft tissue around the tooth that had root canal therapy.
Success rate of root canal retreatment
We believe that the tooth must undergo root canal therapy if the tooth is restorable and has indications for root canal retreatment. Otherwise they will be extracted. Root canal retreatment has lower success rate than initial root canal treatment, because rezching the apical area during the root canal retreatment is not always possible. İn these cases the tooth will need to be extracted. The success rate for retreatment is approximately %70-80.
To learn the success rate of initial root canal therapy you can read our article about root canal treatment.