Thursday, October 4, 2012

Blog of the Day: Re-treatment of Root Canals

Endodontic treatment is one of the most successful forms of dental therapy that is available today.  But approximately 10% of the teeth that are treated will never heal completely or will develop problems later on.

There are several possible indications that there is a problem. You may experience pain or sensitivity on the treated tooth when you bite or put pressure on it. There may be either slight or severe swelling in the treated area.  A fistula (drainage tract) may develop or never fully close. This drainage site will have pus that can be expressed through it. Or you may feel nothing at all. The problem may be something that was discovered through a postoperative radiograph. The bone around the tooth may not have grown back, or there may be more bone destruction seen.

These problems occur for a variety of reasons. The pre-existing infection, the reason for the root canal in the first place, may have left residual effects that never disappeared entirely and have begun to act up again. It is also possible that the original root canal filling was not clinically ideal. This happens due to any of several factors such as severely twisted or curved roots; small, extra canals; separated root canal instruments; cement washout; and others. Sometimes, no clear reason can be seen for the root canal failure. It just happened.

Even if the problem has not been noticed by you, it is not wise to leave an active infection in your body. A nonsurgical retreatment procedure will remove the root canal filling materials, clean and refile the root canal, then refill the canals. The re-treatment is usually more difficult and time consuming than the first root canal.  It is harder to remove condensed, cemented root canal material, cemented posts, and bonded resins or cements in order to re-treat the canals.  Attempts to remove these materials may cause the tooth to fracture and become hopeless. It may not be possible to re-instrument the tooth, based on what is in it. This may not be known until the treatment is begun. It is also possible that re-treatment will not work at all.

Despite these possible problems, re-treatment is the most conservative approach and usually the least expensive approach. When the situation arises, it is the method of choice. It is performed on a tooth that you need to keep. If the re-treatment cannot be done, the problem must be addressed surgically or the tooth will have to be extracted.  A surgical endodontics procedure, called an apicoectomy, may be required if the re-treatment does not work.

Call Omni Dental today at (512) 250-5012 to speak with one of our specialists about the latest ways of enhancing your smile and dental health. You can also go to our website: for more information. 



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