Root Canal Retreatment

Why Do Root Canals Fail?

With proper care, teeth that have been treated with root canal therapy have a high success rate and can last a lifetime. But sometimes, a tooth that has been treated doesn’t heal properly. 

There are four main reasons why root canal therapy may not heal.  They are restorative failures, re-infection, persistent infection and cysts.

Restorative failures: Often when a patient presents with a history of non-healing root canal therapy, one thing that is immediately noticeable is that the tooth has not been properly restored.  What does this mean? After root canal treatment is completed on a tooth, it should have a permanent restoration placed generally within a month after treatment has been completed. This often involves placing a cap or crown on the tooth.  If this is not done within a reasonable period of time the tooth can break or become re-infected with bacteria .

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Another cause for a root canal not healing is a term we call reinfection. This means that the root canal space has been infected with bacteria again.  We see this situation most often when there has been a breakdown of the filling material and or a new cavity in the tooth.

The third cause of why a root canal may not heal has to do with persistent infection. This means that not all of the bacteria present at the initial root canal treatment was properly eliminated from the root canal system. This occurs when not all of the root canals were properly identified and treated. We also see this when the root canal system has been inadequately cleaned and sealed. In some cases, there can be infection on the external surface of the root.

In a small percentage of cases, a cyst can form around the end of the root due to the original infection in the tooth. A small subset of cysts are thought to not be connected to the root canal system and thus persist despite adequate treatment.

The good news is many times these situations are not hopeless and there are treatment options to save your tooth. At Compassion Endodontics we specialize in the diagnosis and treatment of primary and persistent root canal disease.  Because of our training, experience and technology we can offer advanced treatment strategies and a wider array of treatment options to save your tooth even if it has already undergone root canal therapy. From 3-D imaging to state of the art dental operating microscopes with high definition cameras and magnification, we can get to the root of the problem.

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What Happens in a Root Canal Retreatment?

Root canal retreatment is indicated when a tooth with a prior history of root canal therapy is not healing. During the root canal retreatment, access is gained into the root canal system where the root canal filling material is then removed.  After the filling material is removed, Dr. Graham uses ultrasonics and a high power dental operating microscope to locate and painlessly treat the problem.  Retreatment is typically a two-stage process. During the first visit, the root canal filling material is removed and a medication is placed into the canals. At the second visit, the medication is removed and replaced with a permanent root canal filling material and the access is restored.