With good oral hygiene and regular dental care, a tooth that has undergone root canal treatment can last as long as other natural teeth. However, as with any health-related procedure, there will be a small percentage of cases that are not successful. Occasionally, a tooth that has received a root canal may either fail to heal. There are even situations where pain and symptoms develop months or years after the root canal treatment. In these cases, endodontic retreatment may be necessary.
There are several reasons that a tooth may not heal as anticipated after the initial root canal treatment:
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- Curved or narrow canals posing treatment complications
- Undetected canals due to complicated or unusual root anatomy
- Placement of a permanent restoration was delayed, allowing contamination and reinfection
- The permanent restoration did not prevent saliva from contaminating the inside of the tooth
Even teeth that were successfully treated can be compromised by new problems that develop including:
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- New decay that exposes the root canal to bacteria and causes a new infection in the tooth
- A loose, cracked, or broken dental restoration that exposes the tooth to a new infection
- A fracture of the crown or root of the tooth
If it is decided that endodontic retreatment is the most suitable option for you, the involved tooth will be reopened through a small hole in the biting or chewing surface. Restorations that had been placed on the tooth previously may be disassembled to allow access to the canals. Once the canals have been accessed, the previous root canal filling materials will be removed and the inside of the canals cleaned and carefully examined. The tooth is inspected for previously undetected or unusual canals. When all of the canals have been cleaned and prepared, they are then sealed. After the completion of an endodontic retreatment procedure, you may need to return to your restorative dentist for the placement of a more permanent restoration. Root canal retreatment involves local anesthesia and may be completed in one or more visits depending on the treatment required. Success for this type of treatment occurs in about 75-85% of cases. If your tooth is not a good candidate for endodontic treatment or the chance of success is unfavorable, you will be informed at the time of consultation or when a complication becomes evident during or after treatment. You will be able to drive home after your treatment, and you will probably be comfortable returning to your normal routine.
