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Retreatment of failed Root canals


Retreatment of Failed RCT:

Root canal treatments typically last a life time. However in rare circumstances the tooth could become diseased at a later point in time leading to persistent pain, inflammation or presence of draining sinuses.

Is retreatment possible in this instance? If so , will the retreatment save the restored tooth from the previous Root Canal treatment ?

Well, the answer is an emphatic yes. The tooth can be retreated as well as retained for a very long time.

Why is it that a treated tooth develops pain and fails to heal promptly ?

The primary reasons could be any of the following:

  •  • Inability to detect an infected canal (missed canal)during the initial Root canal procedure.

  •  • Inability to secure the canal properly in the first instance, thus leading to recurrence of  infection.

  •  • Delay in fixing the crown or placing a good restoration thus allowing saliva and food particles to contaminate the interior of the tooth.

  •  • Curved root canals not negotiated (cleaned )properly.

The key symptom that indicates a failed root canal is the discomfort in the area around the tooth or the treated tooth itself in terms of tenderness or a sharp shooting pain. Sensitivity while tapping the tooth is another indication . The tissues in the immediate region of the tooth or the root tip could swell up and this swelling could manifest on the patient's face and neck. A lesion near to the tip of the root could accumulate pus and when it drains out it could lead to bad breath.

The procedure for retreatment involves re-opening the tooth, and removal of the root canal filling. Thereafter using a dental microscope the endodontist  searches for any missed root canal or any unusual features in the canal that led to the failure of the first RCT.

Dental microscope and the expertise of the dentist help to detect the missed out/ curved canals. Upon detection, proper cleaning and shaping till the end of the root is done. Then the canal is filled (obturated) till the apex of the root to get a proper apical seal. After that a good restoration/crown is placed on the tooth.

A properly done repeat RCT and crown ensure complete bone healing and the tooth remains in good condition functionally and anatomically for a very long time.

Authored By : Dr. S. Hemamalathi and Dr. K. S Senthil Kumar

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