Endodontic Retreatment

What is endodontic retreatment?

  • In cases of reinfection following a root canal, the problem tooth can be fixed with another treatment. In this situation the previous root canal filling materials are removed, the canals are re-disinfected, and then sealed with a biocompatible material.

Why would you need endodontic retreatment?

  • Occasionally, teeth that have undergone a root canal do not heal as expected for a variety of reasons.

    • Narrow or curved canals were not treated during the initial procedure.

    • Complicated canal anatomy went undetected in the first procedure.

    • Crown placement or other restoration was delayed.

    • The restoration did not prevent salivary contamination to the inside of the tooth. - aae.org

Endodontic retreatment calcification diagram

  • In other cases, a new problem can occur in a tooth that was successfully treated.

    • New decay can expose the root canal filling material to bacteria, causing a new infection in the tooth.

    • A loose, cracked, or broken crown and/or filling can expose the tooth to new infection.

    • A tooth sustains a fracture.

Endodontic Retreatment New Decay Diagram

 What happens during retreatment?

  • First we reopen your tooth to gain access to the root canal filling material.

    • In most cases the restorative materials(crown, post and core material) must be disassembled and removed to gain access to the root canals.

Blocked canal with crown

  • After removing the canal filling, we can clean the canals and carefully examine the inside of your tooth using magnification and illumination, searching for any additional canals or unusual anatomy that requires treatment.

Endodontic retreatment removal of filling material

  • After cleaning the canals, your endodontist will fill and seal the canals and place a temporary filling in the tooth.

    • If the canals are unusually narrow or blocked, surgery may be recommended.

Temporary filling diagram

  • Once the retreatment procedure is complete, you will need to return to your dentist as soon as possible to have a new crown or other restoration placed on the tooth to protect and restore it to its full function.

Endodontic retreatment new crown diagram
 

A few things to note:

As with any dental situation, saving the natural tooth should be top priority. Retreated teeth can last a lifetime and technology is always changing making these procedures better and better all the time.

Check out the video below for more information:

 
 

  • Similar to surgery, the cost will vary based on the complexity of the problem. Typically, the procedure will be more involved than your first root canal due to the removal of restoration material. Therefore, you can generally expect retreatment to cost a little more than the initial root canal.

  • If nonsurgical retreatment is not an option, then endodontic surgery should be considered. Your endodontist will discuss your options and recommend appropriate treatment.

  • If retreatment and surgery are not options, then the only other alternative is extraction of the tooth. This should be thought of as a last resort though, because the procedure is very costly and extensive.