Retreatment of endodontic fillings

Bergenholtz, Gunnar; Lekholm, Ulf; Milthon, Ralph; Heden, Gunnar; Ödesjö, Björn; Engström, B

doi:10.1111/j.1600-0722.1979.tb00675.x

Cited by 147 publications

(191 citation statements)

References 8 publications

(9 reference statements)

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“…A considerable number of clinical studies have discussed the causes of failure of endodontically treated teeth and prospects for prognosis in retreatment . The correlation of RCT failure with infected root canal was evident in several conditions (1,3,(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(24)(25)(26)(27)(35)(36)(37)(38)(39)(40).…”

Section: Criteria For the Rct Successmentioning

confidence: 99%

“…A high rate of failure is associated with endodontically treated teeth associated with AP, overfilling, and teeth that were not properly restored after RCT (18)(19)(20)(21)(22)27,(47)(48)(49).…”

Section: Criteria For the Rct Successmentioning

confidence: 99%

“…The apical constriction and the apical foramen are not reliable anatomic landmarks for the obturation length at the apical end, and their use to calculate obturation length may result in injury to apical and periapical tissues (28). On the basis of biologic and clinical principles, instrumentation and obturation should not extend beyond the apical foramen (18)(19)(20)(21)(22)(27)(28)(29)(30)(31)(32)(33).…”

Section: Operational Strategies That May Interfere On Successmentioning

confidence: 99%

“…Several studies reported that root canal preparation and obturation short of the radiographic apex were associated with a better prognosis (18)(19)(20)(21)(22). The clinical characterization of apical morphology is extremely complex.…”

Section: Operational Strategies That May Interfere On Successmentioning

confidence: 99%

“…The periapical inflammation may occur due to a natural defense response against overinstrumentation, over-irrigation or overfilling (18)(19)(20)(21)(22). The root canal preparation and obturation should be restricted to the main root canal if there is no evidence contrary to this therapeutic protocol.…”

Section: Root Canal Infection and Its Consequencesmentioning

confidence: 99%

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Characterization of Successful Root Canal Treatment

et al. 2014

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Knowing the outcome of root canal treatment (RCT) is determinant to substantiate the clinical decision making process, especially when RCT is weighed against the extraction of natural teeth or replacement by prosthetic elements. The ideal scenario in all clinical situations should combine healing/prevention of disease (apical periodontitis) and the functional retention of the tooth. Understanding the risk factors associated with endodontic failure is a key factor to increase the chances of success. The logical action is to reverse the existing disease, which requires intervention to neutralize the bacterial invasion and disrupt the bacterial biofilm within the complex anatomy. Success is more predictable when the immune host defenses are favorable. However, success has different meanings to the dentist, to the patient and to the tooth itself. The life of an endodontically treated tooth depends on the accuracy of the diagnosis and planning, excellence of disinfection, instrumentation and filling procedures (antimicrobial strategies, root canal shaping and coronal and apical seal) and finally the rehabilitation management. The interpretation of constant or intermittent pain and/or discomfort associated with apical periodontitis (AP) in endodontically treated tooth may be suggestive of endodontic failure. The success features of RCT, namely absence of pain, regression of AP, tight seal of canal and coronal spaces, and recovery of tooth function, must be reevaluated over time. In case of doubt between success and failure, cone beam computed tomography (CBCT) could be indicated for detection and precise localization of AP. The possibility of map reading on CBCT images characterizes the real multidimensional structure, providing accurate information on the presence, absence or regression of AP. The survival of an endodontically treated tooth implies understanding the biological and mechanical outcomes as multifactorial events over the individual's life span. The objective of this review of literature is to discuss relevant factors associated with patient's health, tooth and dentist that could account for a successful RCT.

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Section: Criteria For the Rct Successmentioning

confidence: 99%

Section: Criteria For the Rct Successmentioning

confidence: 99%

Section: Operational Strategies That May Interfere On Successmentioning

confidence: 99%

Section: Operational Strategies That May Interfere On Successmentioning

confidence: 99%

Section: Root Canal Infection and Its Consequencesmentioning

confidence: 99%

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Characterization of Successful Root Canal Treatment

et al. 2014

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Frequency of apical periodontitis in root‐filled teeth restored with post and core: A 5‐year retrospective study

Johansson,

Sjögren,

Wirén

et al. 2024

Clinical & Exp Dental Res

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BackgroundIn conjunction with post placement in root‐filled teeth with periapical healthy conditions, root canal retreatment may be performed to improve the seal of the root canal. Whether root canal retreatment for technical reasons (retreatments in teeth without apical periodontitis (AP)) results in lower frequency of AP is unknown.ObjectiveTo examine whether there is a difference in frequency of AP between roots with root canals retreated for technical reasons, and roots with root canals not retreated before post placement, with a minimum follow‐up of 5 years. Also, to examine changes in root filling quality following root canal retreatment for technical reasons.MethodsThis retrospective study included radiographs of 441 root‐filled roots without periapical radiolucencies at baseline, scheduled for post and core treatment. Follow‐up data for a minimum of 5 years were available for 305 roots (loss to follow‐up 30.8%), 46 of which were retreated for technical reasons. Two calibrated observers assessed root filling sealing quality and length, respectively, and periapical status according to the Periapical Index. The main outcome of the study, AP, was used as the dependent variable and all analyses were performed at root level.ResultsThe overall frequency of AP at follow‐up was 13.8%. The difference in frequency of AP between retreated (4.3%) and nonretreated (15.4%) root canals was not statistically significant, p = .061. Analyses including only roots with preoperatively inadequate root filling quality showed a statistically significant difference (p = .017) between the two treatment groups (2.4% vs. 22.9%).ConclusionsRoot canal retreatment for technical reasons before post and core placement significantly reduces the frequency of AP in roots with inadequate root filling quality.

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A Comparison of Retreatment Decisions Among General Dental Practitioners and Endodontists

Balto

Al‐Madi

2004

Journal of Dental Education

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This study compared the difference in decision making regarding retreatment of endodontically treated teeth by general dental practitioners and endodontists. Thirty radiographs of endodontically treated teeth taken from undergraduate records with their respective case descriptions were submitted to fifteen endodontists and fifteen general dental practitioners. Seven treatment alternatives were given as choices; reasons for retreatment, if chosen, were also requested and presented as choices. The results showed statistically different decisions among these two groups regarding retreatment cases. More endodontists opted for retreatment of cases, while higher percentages of general dentists decided to observe, not treat or extract. To prevent misdiagnosis and eventually mistreatment, endodontic decision making should be taught. Currently, there are no specific guidelines for management of failed root canal retreatment. It is suggested that guidelines generated by evidence-based dentistry may produce less variation in clinical decision making.

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Retreatment of endodontic fillings

Cited by 147 publications

References 8 publications

Characterization of Successful Root Canal Treatment

Characterization of Successful Root Canal Treatment

Frequency of apical periodontitis in root‐filled teeth restored with post and core: A 5‐year retrospective study

A Comparison of Retreatment Decisions Among General Dental Practitioners and Endodontists

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