Endodontic retreatment—Case selection and technique. Part 1: Criteria for case selection

Abstract

The question of retreating a tooth that has had previous endodontic treatment is a common occurrence in dental practice. However, the mention of endodontic retreatment as such in the literature is minimal. It might be due to the failure to recognize endodontic retreatment as varying in many respects from primary endodontic treatment. Considering retreatment of an endodontically treated tooth raises several questions: Is it worth damaging a successful restoration in order to gain access to the root canals (1)? Is it necessary to retreat a case just because it seems radiographically unsatisfactory and what are the chances of improving the filling by retreatment (2)? What are the chances of success in cases where previous treatments failed, especially when no apparent reason can be suggested for failure? How do you relate to the patients' increased awareness to these questions in cases of retreatment? These questions affect the subjective interpretation of information which is the basis for case selection in endodontics (3). The difficulty in decision making is coupled with the reduced rate of success in endodontic retreatment (2, 4). This complexity of case selection in endodontic retreatment was recently demonstrated by the marked variation of treatment plans of endodontic failure cases included in a survey among general dental practitioners and endodontists (5). In addition, modified techniques must be used in endodontic retreatment to overcome obstacles of a nature and incidence not encountered in primary endodontic treatment. It is the purpose of this article to discuss the criteria for case selection in endodontic retreatment, as well as the specific techniques existing for retreating endodontically treated teeth. 28 CRITERIA FOR CASE SELECTION IN ENDODONTIC RETREATMENT