Root canal therapies are one of the most effective dental treatments that permanently relieve tooth pain and strengthen the tooth structure. However, in some cases of root canal treatment, the surrounding tissue may not heal as expected.
In such cases, endodontic retreatment may be required to remove the underlying cause of persistent pain. Moreover, they allow the surrounding tissue to heal correctly while still saving the integrity of the tooth in the mouth.
Typically, endodontic retreatment includes the removal of the old filling, followed by cleaning and shaping the root canal. Once the canal is clear, it is filled with medicaments and rubber-like material called gutta-percha.
Today’s article will highlight the indications and procedures of endodontic retreatment. Furthermore, we will discuss the alternatives and costs of endodontic retreatment.
What is root canal retreatment?
Usually, most teeth are treated with root canal therapy, lasting as long as other natural teeth are in the mouth. In some cases, the root canal treatment, also known as endodontic therapy, may fail to heal correctly. This leads to pain and discomfort even after the root canal procedure.
In such situations, endodontic retreatment is one of the most viable options for saving the integrity of the tooth by permanently removing the underlying cause of failure. (1)
It is best to get advice from your dentist to consider all available options for your dental condition. With the advances in technology today, the techniques used in performing endodontic treatment are much better than those used in earlier times. Today, endodontically retreated teeth can function for a long time and, in most cases, even for a lifetime.
When is endodontic retreatment performed?
Several reasons can lead to the failure of healing after root canal treatment. Such cases are ideal for retreatment. Some of the indications may include –
- Too narrow root canals or curved root canals that could not be adequately accessed during the initial procedure.
- Complicated canals that could not be detected in the initial procedure.
- A delay in the placement of the dental crown or even restoration after obturation increases the risk of reinfection. (2)
- The inability of the restoration to prevent salivary contamination inside of the tooth.
- Loose, cracked, or broken dental crown or tooth filling can increase the risk of reinfection.
- Traumatic fracture to the treated tooth.
What is the procedure for root canal retreatment?
The procedure for endodontic retreatment is more or less similar to that of a routine root canal treatment. It is typically performed in the following steps –
- First, the dentist may reopen the tooth of interest by drilling through the filling. If there is a crown, it is more likely removed before getting access to the root canals. Accessing the root canal through the filling material is usually more complicated than a routine root canal.
- The root canal filling – gutta-percha is removed thoroughly, followed by cleaning of the root canals. The dentist, at this point, may examine the tooth using magnification and illumination.
- The dentist also looks for accessory canals that may have been missed during the initial procedure. (3)
- After thorough cleaning and examining of the canals, the dentist will start filling the root canals back with new gutta-percha material.
- It is advised to get permanent tooth filling and crown replacement as soon as possible after the completion of root canal treatment. This helps to eliminate the risk of reinfection.
Are there any alternatives for endodontic retreatment?
Some patients may not be convinced to get endodontic retreatment as they are afraid it might fail again. The dentist helps to provide the best treatment options suitable for the patient. However, Unfortunately, there are not many alternatives to endodontic retreatment. (4)
One best alternative to this treatment is tooth extraction, followed by replacement of the missing tooth with an implant, dental bridge, or denture. However, this option may usually require extensive surgical procedures and the involvement of adjacent healthy teeth. Moreover, it is more time consuming and expensive as compared to endodontic retreatment.
What is the cost of endodontic retreatment?
The cost of endodontic retreatment varies, depending on the type of tooth, the location of the tooth, and the complications that arise during the procedure. Usually, endodontic retreatments are more complex than the initial root canal treatment. Additionally, it takes more time and effort to perform retreatment.
This is one of the reasons why endodontic retreatment is slightly expensive than routine root canal treatments. Typically, the cost of endodontic retreatment may range between $ 800 – $1500 per tooth.
Most dental insurance cover part or all of the cost for endodontic retreatment, but some policies limit coverage to a single tooth procedure at a given period. If you are planning to get endodontic retreatment, talk to your insurance company and get an estimate of cost coverage.
Take away message
Endodontic retreatments are one of the rarest dental procedures performed due to the failure of the previous root canal therapy. Some of the indications for endodontic retreatment include narrow or curved canals, broken tooth filling, inability to get a dental crown, and missed canal.
The procedure typically involves the same steps as a routine root canal treatment. However, it is more complicated due to the removal of the root canal filling and assessment of extra canals. Additionally, it is a more time-consuming procedure.
Tooth extraction is the only alternative to endodontic retreatment. Therefore, it is best to ask a dentist and weigh your options before deciding the best treatment.
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