Some patients have an endodontically treated tooth that fails to heal — or is causing pain — months or even years after successful treatment. When this occurs, the tooth may often be saved by a root canal retreatment
There are several reasons that a tooth may not heal after initial root canal therapy. For starters, the anatomic structure of the tooth’s canal system can make treatment difficult; narrow or curved canals may go undetected. Next, tooth trauma can cause the root to fracture, which can cause a new infection resulting in a loose, cracked or broken crown or filling. A second root canal may also be necessary if coronal leakage occurs, which is when decay and bacteria invade a tooth under a loose filling or ill-fitting crown. When coronal leakage enters the filled root canal system, it can cause contamination and failure of treatment
What happens during retreatment? When a tooth needs to be retreated, our highly-trained endodontists gently reopen the canals and with the help of a dental operating microscope remove the infection. We then sterilize and refill the canals. In many cases, restorative materials such as crowns and posts need to be removed in order get to the root canal. Our root canal specialists will always try to preserve the original crown, if possible. If we determine that your existing crown is sealing and functioning properly, a small opening will be drilled in the crown that can later be restored by your general dentist. Finally, for patients who have complex curved canals or blockage in the canals, we may recommend apical surgery, also known as apicoectomy.