As occasionally happens with any dental or medical procedure, a tooth may not heal as expected after initial treatment for a variety of reasons.
Why do I need another endodontic procedure?
- Narrow or curved canals were not treated during the initial procedure
- Complicated canal anatomy went undetected in the first procedure
- The placement of the final restoration or crown was delayed following endodontic treatment
The restoration did not prevent salivary contamination to the inside of the tooth In other cases, a new problem can jeopardize a tooth that was successfully treated. For example:
- New decay can expose the root canal filling material to bacteria, causing a new infection in the tooth
- A loose cracked or broken down filling can expose the tooth to bacterial contamination
- The tooth sustains a fracture
What will happen during retreatment?
First, the endodontist will discuss your treatment options. If you and your endodontist choose retreatment, the endodontist will reopen your tooth to gain access to the root canal filling material. In many cases, complex restorative materials—crown, post and core material—must be disassembled and removed to permit access to the root canals.
After removing the canal filling, the endodontist 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.
After cleaning the canals, the endodontist will fill and seal the canals and place a temporary filling in the tooth. If the canals are unusually narrow or blocked, your endodontist may recommend endodontic surgery. This surgery involves making an incision to allow the other end of the root to be sealed.
After your endodontist completes retreatment, 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.
Are there any other options?
Occasionally, retreatment is not possible. In that case, endodontic microsurgery may be needed.
The only other alternative is extracting the tooth. The extracted tooth must then be replaced with an implant, bridge, or removable partial denture to restore chewing function and to prevent adjacent teeth from shifting. Because these options require extensive surgery or dental procedures on adjacent healthy teeth, they can be far more costly and time consuming than retreatment and restoration of the natural tooth.