Root canal re-treatment is the best choice for a failing root canal treatment.

Root canal treatment may fail or become problematic for many reasons, such as not being suitably restored resulting in extensive unmanageable dental decay,  an untreatable crack extending into the root and/or due to the complex root canal system not being adequately disinfected. It is also not uncommon for a root canal not to have been located, disinfected and sealed.

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(Top left), a discoloured and (Top right) poorly root treated and infected tooth, which was re-root treated  (lower left) 2 years later the tooth looks great and is healing up very well. The patient has avoided a dental implant. Click on the image to enlarge.

If the root canal system has been thoroughly disinfected, sealed to prevent reinfection, and restored to a high standard with a carefully executed bonded restoration or crown then root canal treatment is more likely to be successful in the long-term.

Root canal re-treatment is carried out to a very high standard here at Dawood Tanner, and the survival rate can be over 90% (similar to that of an implant retained crowns). In some instances root canal re-treatment may not be viable, but this may only become apparent once the treatment has commenced. For example, the tooth may not have sufficient remaining sound tooth structure remaining to restore it with a crown. In other instances, it may not be possible to completely remove the existing root filling material and thoroughly disinfect the root canal system. In these cases, extraction may be advised and the tooth replaced with an  implant retained crown, a bridge, or occasionally a denture.

If the tooth is well restored but the canal obstructed, an apicectomy or root end resection, which is the most common endodontic surgical procedure, may be used to eliminate the inflammation or infection that may persist in the bony area around the tip of the root. In this procedure, the endodontic specialist lifts the gum tissue near the tooth to expose the underlying root; the infected tissue is removed and the very end of the root is trimmed with a fine ultrasonic instrument. A biocompatible filling may then be placed to seal the root canal. Local anaesthetics make the procedure comfortable, and most patients return to their normal activity the next day; treatment under intra-venous sedation is of course also available as an option.

  

(Left image):  An inadequate root filling with signs of an associated infection (shadow) in the jaw bone. (Middle image): The tooth has been thoroughly disinfected and sealed with a root canal filling. (Right image): The tooth was restored with a crown, and 2 years later the sign of infection (shadow) at the tips of the roots has completely regenerated with new bone.