Even when pain and/or swelling which are signs of infection are present, the majority of cases of root canal treatment failure can be successfully treated in the technologically advanced world of today. By the improved researches and the clinical trials the dental professionals have developed a lot better concepts, materials, and techniques. Also now the quality of education and exposure has produced better trained general dentists and even many specialists in the field. All these factors help in providing better care to the patient.
The dentists are now able to treat the root canal cases with better diagnosis and visualization.
In case of root canal failure, 2 options are available. Patient can either opt for:
1. Non-surgical endodontic re-treatment or can get
2. Surgical endodontic procedure done (Apicoectomy with retrograde filling)
Today, well-trained general dentists and root canal specialists alike can most of the times perform non – surgical endodontic root canal retreatment which is very cost effective, time saving and quite predictable as compared to other treatment alternatives like tooth extraction.But at times the root canal failure case cannot be re-treated by non-surgical methods. In these cases it’s important to use surgical endodontics to re-treat a root canal failure case preferred over tooth extraction.
Non-Surgical Root Canal Retreatment Method
The main aim of Non-surgical endodontic procedure is to save the endodontically failed tooth. But at times, patients crown given on the tooth requiring re-treatment needs to be removed. In some cases access can be made possible through the existing crown. The access opening as done in fresh case will give the dentist a non-surgical access to the root canal of the tooth through the top surface of the tooth. When the access has been effectively gained the procedure may further involve the following steps:
1. Locating and treating the earlier missed or undetected canals.
2. Removing the earlier filled material from the root canal space. Drills or chemical agents can be used to remove the existing filling.
3. Post and core removal or any broken instrument from the pulp space.
4. Improving the quality of already present root canal treatment. Making way through the blocked canals and by-passing canal ledges.
5. Treating if any mechanical and pathological perforations of the root present. Once these objectives are achieved, the root canal space is cleaned well, re-shaped, completely disinfected and finally sealed with complete accuracy. A protective restoration can then be placed in the end to restore the proper tooth form, function and aesthetics.
Number of Appointments for Root Canal Retreatment Procedure
Mostly root canal retreatment is done in 2 -3 sittings. In first sitting, root canal retreatment procedure is performed and in follow up appointment, tooth is restored with dental crown which will further restore functions of tooth.
Pain after Root Canal Retreatment
Patient may experience some pain, soreness and tenderness for several days after root canal retreatment procedure. For pain relief after root canal retreatment, patient can take pain medicines such as ibuprofen, Motrin or aspirin. If pain and discomfort doesn’t regress or gets worse after few days, then patient can visit his dentist. After root canal retreatment, patient should schedule a routine follow up appointment.
Care after Root Canal Retreatment
1. After root canal retreatment, patient should avoid chewing from that side of the mouth.
2. Patient should take the pain medicines as directed and should take soft foods at least for 2 days after procedure.
3. Patient should avoid intake of very hot and cold foodstuffs and should avoid smoking, drinking and any stressful exercise as it will interfere with healing.
4. To reduce swelling after root canal retreatment procedure, intermittent ice pack application can be done.
How Successful Is Root Canal Retreatment Procedure
Root canal retreatment will remove the infection from the tooth and will relieve pain and discomfort of the patient. Root canal retreatment saves natural tooth structure and treated tooth can function for years and can function throughout life. Success rate and prognosis of root canal re-treated tooth is not as good as root canal treatment done for the first time. If root canal retreatment is unsuccessful, then patient can get endodontic surgery done or can opt for tooth extraction with replacement of missing tooth with dental implants or dental bridge.
Complications of Root Canal Re-Treatment
Root canal retreatment is a safe procedure but complications may occur after procedure. Re-infection or tooth damage may occur after root canal retreatment. To avoid any complications after root canal retreatment, procedure should be done by an experienced endodontist. Patient should follow instructions of his endodontist after procedure.