Root Canal Retreatment
Although root canal treatment has a high rate of success, occasionally a treated tooth may not heal as expected or may develop new problems over time. In some cases, the tooth may continue to show signs of infection or inflammation, while in others, symptoms may return after a period of healing.
There are several reasons why a tooth may not heal properly, including:
- New decay developing in the tooth
- A new fracture or crack in the tooth or root
- A loose, cracked, or broken filling or crown, allowing bacteria to re-enter the tooth
- Narrow, curved, or complex canals that were difficult to identify or treat during the original procedure
- Previously undetected canal anatomy, including additional or unusually shaped canals
- Delayed placement of the permanent restoration, which can increase the risk of leakage, fracture, or reinfection
- Persistent or recurrent infection within the root canal system
- Complexities associated with the original root canal treatment that may have prevented complete cleaning, disinfection, or sealing of the canal system
If a tooth does not heal as expected, an endodontic evaluation can help determine the cause and identify appropriate treatment options. Depending on the circumstances, retreatment or another procedure may be recommended to give the tooth the best opportunity for healing and long-term preservation.
Understanding Endodontic Retreatment
After your tooth has been evaluated and endodontic retreatment is determined to be appropriate, an appointment will be scheduled to complete the procedure.
At the beginning of your appointment, the tooth and surrounding area will be carefully numbed with local anesthesia to ensure your comfort. A rubber dam will then be placed to isolate the tooth and keep the treatment area clean and free of saliva.
An access opening will be made through the existing restoration to allow access to the root canal system. Depending on the existing restoration, any core material, posts, or other materials within the tooth may need to be removed to provide adequate access to the canals. These materials will be addressed by your general dentist when the tooth receives its final restoration.
The existing root canal filling material will then be carefully removed. The canals are thoroughly cleaned, disinfected, and reshaped to address any remaining bacteria or debris. The tooth will also be carefully examined under a dental operating microscope to identify additional canals, fractures, or other factors that may have contributed to the need for retreatment.
Once the canals have been adequately cleaned and prepared, they will be sealed with new root canal filling material. A temporary filling will then be placed to protect the tooth until your general dentist can complete the permanent restoration.
Depending on the condition of the tooth, the complexity of the root canal system, and the findings during treatment, retreatment may be completed in one or two appointments.
Following retreatment, you will need to return to your general dentist to have the existing restoration repaired or replaced, as appropriate. We generally recommend that the permanent restoration be completed 2 months following retreatment.
Timely placement of the final restoration is an important part of protecting the tooth and supporting the long-term success of your endodontic treatment.