Retreatment

Retreatment

Even when a tooth has received root canal treatment, it might still become reinfected. The patient will usually notice a returning dull pain, and the general feeling will be that “something is not right”.

More often than not the tooth in question is not the cause of pain. Moreover, the inflammation may not be visible until the area is looked at in an x-ray. The area affected, around the root tips, will show up on the x-ray as a dark spot.

When retreatment is necessary

If, following root canal treatment, bacteria have remained in the canal system of the tooth root, or if they have returned after the treatment, renewed inflammation may result. This is when renewed treatment, retreatment or revision of the old root canal treatment is necessary. Common causes may include:

• Canals have been overlooked or they have not been treated in their entirety, ie in their entire length or width
• Cleaning out the canal system could not be done sufficiently due to the complex anatomy of the patient’s root canal
• Tooth decay, leaking fillings or late treatment with a crown may have resulted in bacteria entering the root canal system for a second time

How is retreatment carried out?

In the event of renewed inflammation we remove the previous root filling and clean out the entire root system, including any root canals that might have been overlooked. Filling and sealing is then done again.

Retreatment is more complex and lengthy than your primary root canal treatment since the old root filling and remaining tissue will need to be removed. If retreatment is not successful, apicoectomy — removing the root’s apex along with the surrounding damaged tissue — is the last option we have. If it becomes clear that the inflammation is not going away, the retreated tooth should be replaced with an artificial tooth.

Success rates for retreatment are around 60% to 85%. During your initial treatment we will give you an estimate of the likeliness of success for your individual treatment.

What do we do if a root canal treatment is failing

When a dental nerves dies as a result of trauma, it is accompanied by inflammation in the root tips. This inflammation may affect your general health, not just your mouth. It is therefore vital that both the tooth and the root canals be disinfected up to the root tips. Here you can see a four-channelled back tooth with cleaned out canals.

The canals are sealed using cement and rubber-like pins made from gutta percha.

The tooth then receives a filling for restabilisation. In order to achieve long term stability, ceramic partial crowns or regular crowns are a suitable option.

Here is an X-ray showing a tooth with a root filling. The rubber tips fit perfectly into the tip of the dental root.

For more information regarding this treatment