Failed root canal next step

Retreatment is one option after failed primary root canal therapy. Root canal treatment works by opening the tooth, removing infected pulp, cleaning and shaping the inside, then filling and sealing it.

Endodontic surgery is the other recovery route after persistent disease or root canal failure. It removes the root apex and closes the root canal from the surgical end.

A root canal course usually takes two or more appointments lasting one to two hours or sometimes longer. A temporary filling may sit between visits, and a crown may be needed when the tooth was badly infected.

The systematic review found that surgical retreatment appeared more favourable for healing over the short two-year period. The review also noted a small number of participants, which limits how firmly that finding can be applied.

Reported failures included underfilling, overfilling, poorly condensed canal filling, broken instruments and loss of the coronal seal. Vertical root fracture was also identified as a major cause of failure after surgical endodontic treatment.

A persistent endodontic lesion or a failed root canal creates the comparison between nonsurgical retreatment and endodontic surgery. Both aim to recover the tooth rather than move directly to a different replacement route.

The question is whether to retreat the canal through the tooth or approach the root end surgically. These are separate approaches studied for persistent disease and failure after primary root canal therapy.