Nonsurgical Endodontic Retreatment Research Articles

Accuracy of Dynamic Navigation for Non-Surgical Endodontic Treatment: A Systematic Review.

In recent years, the application of Guided Endodontics has gained interest for non-surgical endodontic treatment and retreatment. The newest research focuses on the accuracy of Dynamic Navigation (DN). This article systematically reviewed existing data on the accuracy of non-surgical endodontic treatment procedures that were completed using DN. Following the PRISMA criteria, an electronic database search was conducted in PubMed, Web of Science, Scopus, and Cochrane Library. Studies comparing the accuracy of non-surgical endodontic treatment using DN and the conventional freehand technique were eligible. The literature search resulted in 176 preliminary records. After the selection process six studies were included. The risk of bias was evaluated using the modified Cochrane Collaboration Risk of Bias 2.0 tool. Five studies examined the aid of DN for planning and executing endodontic access cavities, and one for fiber post removal. In two studies, endodontic access cavities were performed in teeth with pulp canal obliteration. The main outcomes that were measured in the included studies were preparation time, global coronal entry point and apical endpoint deviations, angular deviation, tooth substance loss, qualitative precision, number of unsuccessful attempts or procedural mishaps. The risk of bias was rated from low to raising some concerns. Overall, DN showed increased accuracy compared to the freehanded technique and could be especially helpful in treating highly difficult endodontic cases. Clinical studies are needed to confirm the published in vitro data.

The Novel Role of Solvents in Non-Surgical Endodontic Retreatment

Non-surgical endodontic retreatment is a reliable conservative option for managing post-treatment apical periodontitis. However, effective microbial control, based on the maximization of filling removal and disinfection protocols, is not yet predictable. Traditional gutta-percha solvents, which are indistinctively used for both the core and sealer filling materials, became obsolete due to unprecedented advances in endodontic technology. Nonetheless, microtomography, scanning electronic microscopy findings, and histobacteriological analysis tend to confirm the persistence of filling materials and the lack of association between root canal enlargement and superior disinfection. There is a controversy regarding the most suitable clinical protocols surrounding the shaping procedures and the supplementary disinfection steps. Based on the literature and the previous work of the team, the authors aimed to summarize the current knowledge regarding specific solvent formulations that target filling materials. Additionally, the advantage of an additional irrigation step to optimize disinfection was highlighted. This adjunctive procedure serves a dual role in the dissolution of filling materials, and in conferring an antibiofilm effect. Further research is needed to understand the novel contribution of these strategies upon clinical practice outcomes.

The Efficacy of Two Novel Retreatment Systems in the Removal of Root Canal Obturating Materials (An In vitro Study)

BACKGROUND: The complete removal of root filling material is one of the main goals of non-surgical endodontic retreatment. Thus, the development of new techniques and instruments aiming to promote this task presents clinical significance. AIM: The purpose of the study was to assess the amount of residual root canal filling materials (gutta-percha/sealer) after using two different endodontic retreatment systems and ultrasonic tip. METHODS: Forty-five mandibular premolar teeth were mechanically instrumented and obturated. Retreatment was performed using two different Endostar RE (Group 2), Rogin retreatment system (Group 3), and ultrasonic tip (Group 1). Roots were separated buccolingually into two halves. A digital camera connected to the stereomicroscope captured images to each half. Image-J software was used to evaluate and measure the areas with remaining filling material in each third (cervical, middle, and apical). RESULTS: Data analysis revealed significant differences between the groups in the coronal, middle, and apical thirds (p < 0.05). The ultrasonic retreatment tips (G1) were significantly more efficient in removing the gutta-percha and sealers compared to the Rogin (G3) and Endostar (G2) retreatment endodontic kits. CONCLUSIONS: All the file systems left some filling material in the canals. Ultrasonic retreatment tip had maximum efficacy for the removal of filling materials in comparison with the retreatment file systems under investigation.

Endodontic retreatment: significance and a systematic review of te major protocols

Introduction: In the endodontic treatment scenario, despite the emergence of techniques and instruments that facilitate the treatment, there are still cases that require retreatment of the treated root canals. Non-surgical endodontic retreatment (NSER) can be performed in one or several visits. Endodontic pain has been the main reason for patient consultations after therapy and affects patient comfort. A condition for successful endodontic retreatment is proper cleaning of the root canals, therefore, special attention must be given to the technique used to remove the filling material, with the most commonly used cement, pastes, and gutta-percha cones. Objective: This systematic review aimed to evaluate the main protocols and techniques for endodontic retreatment. Methods: The present study was followed by a systematic literature review model. Clinical studies were included as case reports, retrospective, prospective and randomized trials with qualitative and/or quantitative analysis. The quality of the studies was based on the GRADE instrument. The risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: The results showed that cleaning and the presence of debris at a speed of 1500 rpm provided greater agility with a smaller number of fractured instruments. Furthermore, the dynamic navigation system enabled the minimally invasive removal of the fiber post with a high degree of precision, without unnecessary removal of the root structure. One visit NSER had lower postoperative pain than multiple visits only for 1 and 30 days. Ultrasonic tips should be considered a good option for endodontic retreatment, especially for cases of bioceramics. Finally, there is a predominance of E. faecalis and P. gingivalis in all phases of endodontic retreatment.

Non surgical retreatment of central incisor in endodontics: A case report

Introduction: Preservation of tooth has continuously been of maximum problem to dental practitioners on the grounds that ages. Also on this growing technology sufferers are greater aware of to be had remedy plan and its outcome. Long time period fulfillment of endodontic remedy is predicated on thorough debridement of the foundation canal gadget accompanied with the aid of using 3 dimensional obturation. Endodontic disasters aren't exception and consequently want retreatment. Case report: A 23 yr antique male affected person turned into noted the endodontist with a first-rate grievance of ache in higher the front teeth. Clinical exam found out a discoloured maxillary central incisor. The affected person directly supplied a records of root canal treatment attributed to the discoloured enamel which turned into accomplished one and a 1/2 of month in the past through a widespread practitioner. A prognosis primarily based totally on medical symptoms and symptoms i.e. lack of coronal seal with insufficient obturation turned into hooked up and affected person turned into satisfied for a nonsurgical endodontic retreatment. Conclusion: At only a graduate degree the information concerning remedy like root canal treatment is minimum and basic. This case file is a easy endodontic retreatment case, finished via way of means of the conventional technique of eliminating the gutta-percha. Every dentist ought to have a complete information of the basis canal anatomy and its feasible versions earlier than taking off root canal treatment.

Intentional Replantation: an Approach to Save Hopeless Natural Teeth (A Case Report)

Introduction: Non-surgical endodontic retreatment and surgical endodontic therapy may not be practical for the treatment of endodontic diseases. Intentional replantation is considered as a procedure of last resort when nonsurgical or surgical endodontics is contraindicated. Case report: A 35 year- old female attended the endodontist office with pain and apical lesion in endodontically treated tooth ≠47. Access preparation for retreatment is a problem due to the posts and crown and surgical endodontic therapy was limited by anatomical features including nerve proximity and bone thickness. In addition, the patient could not afford to pay for non-surgical re-treatment or implant therapy Conclusion: This report demonstrates intentional replantation as a treatment that can be considered when other options such as endodontic retreatment or apical surgery are impossible.

Fractal analysis and periapical index evaluation of multivisit nonsurgical endodontic retreatment: A retrospective study

This retrospective study compared changes in periapical trabecular patterns using fractal analysis and the periapical index (PAI) on the periapical radiographs of patients who underwent multivisit nonsurgical endodontic retreatment of persistent periapical disease. In total, 50 participants were included in the study. For each patient, baseline periapical radiographs were acquired just before retreatment and postoperative radiographs were acquired 1 year later. The region of interest, located in the abnormal tissue around the root apex, was selected from each of the paired radiographs and the fractal dimension (FD) was calculated. Periapical status was classified using the PAI as "healed" (PAI <3) or "unhealed" (PAI ≥3). According to the PAI scores, retreatment after 1 year had a healing rate of 70%. In healed cases, the FD values increased significantly (P < .001), whereas FD decreased significantly in unhealed cases (P = .021). Change in FD was significantly different between healed and unhealed cases (P < .001). However, change in FD did not have a significant correlation with PAI in either healed or unhealed cases (P > .05). There was no significant effect of sex on the change in FD values in either healed or unhealed cases (P ≥ .690). The significant differences in FD suggest that this parameter may be useful in detecting increased trabeculation and estimating retreatment prognosis.

Endodontic Retreatment in Underfilled Root Canal of Maxillary First Molar with Chronic Periapical Abscess: A Case Report

Background:The failure of endodontic treatment commonly caused by imperfect obturation, periodontalperiradicularlesions, untreated root canals, and some other factors. The failure may trigger the occurrenceof secondary infections due to persistent. bacteria.One of the abnormalities that appear after endodontictreatment is a periapical abscess.Endodontic failure can be overcome by endodontic retreatment, apicalsurgery, or extraction. During an endodontic retreatment, endodontic instruments are used to remove theroot canal filling material and to repeat the steps of endodontic treatment to achieve the apical patency.Purpose: This case report presents management to overcome the failure of previous endodontic treatmentwith nonsurgical endodontic retreatment. Case: A 66 years old male patient came with a dull pain oftooth no 16 and uncomfortable when used for chewing since 2 months after endodontic treatment. Theepisodic swelling appeared since 3 months ago which then deflated.The objective examination showed apositive response to bite test and percussion test. Intraoral periapical radiograph confirmed an underfilledroot canal, and a periapical radiolucency with a diffuse border on palatal root. Case Management: Basedon the patient’s history taking, radiographic, and clinical examination,endodontic retreatment was doneand followed by porcelain fused to metal crown restoration. Conclusion: Endodontic retreatment is theappropriate treatmentoption to overcome the failure of the previous endodontic treatment that accompaniedwith a periapical lesion and to preserve its function in stomatognatic system.

Retrospective fractal analyses of one-year follow-up data obtained after single-visit nonsurgical endodontic retreatment on periapical radiographs.

The aim of retrospective study was to evaluate the changes to the periapical bone sites after non-surgical endodontic retreatment by using fractal analysis on periapical radiographs. Thirty patients whose teeth had periapical lesions and underwent primary endodontic treatment were selected for nonsurgical single-visit endodontic retreatment. Two radiographs were taken, the first immediately after retreatment and the second at the 1-year follow-up. An identical region of interest close to the infected root apex was selected from each radiograph. FD was measured using the box-counting method. Periapical status was evaluated using the periapical index (PAI). Treatment outcomes were categorized into healed (PAI < 3), or not healed (PAI ≥ 3) based on radiographic criteria. The mean FD value significantly increased at the 1-year follow-up compared to baseline. No significant sex biases were apparent. According to the PAI, retreatment after 1year resulted in a 63.3% healed. The extent of periapical trabecular bone evident radiographically increased, as revealed by FD data, 1year after endodontic retreatment. Clinical relevance The use of fractal analysis as a quantitative method to evaluate changes in periapical trabecular bone (such as healing and inflammation) after endodontic retreatment can be an important marker in determining the prognosis of endodontic retreatment.

POSTOPERATIVE PAIN AFTER ENDODONTIC RETREATMENT USING DIFFERENT RETREATMENT SYSTEMS: A RANDOMIZED CLINICAL TRIAL

Aim: This study aimed to compare the effect of various nickel-titanium rotary retreatment systems on intenstiy of postoperative pain after non-surgical endodontic retreatment. Materials and methods: One hundred and eighty patients requiring endodontic retreatment were included in the study. The patients were randomly assigned into three groups of 60 patients, according to the method used to remove old canal filling material. In group 1, canal filling material was removed using ProTaper Universal retreatment (PTUR) instruments. In group 2, the canal filling material was removed with D-Race retreatment instruments. In group 3, Mtwo instruments were used to remove canal filling material. Teeth were then medicated with calcium hydroxide and sealed using temporary filling material. The presence of postoperative pain was assessed after 6, 12, 24, 36 and 72 h, 7 days. Results: Among the three groups, the highest postoperative pain scores were recorded 6 hours after the procedure; the postoperative pain scores decreased over time in all time intervals. In 6 hours, Mtwo group exhibited higher pain score than those of D-RaCe group (P < .05), but there was no difference in the pain scores between D-RaCe and PTUR group; Mtwo and PTUR (P >.05). Conclusions: Retreatment files tested in this study caused similar postoperative pain levels after non-surgical endodontic retreatment, except at 6 hours. Keywords: Endodontics; postoperative pain; retreatment ÖZ Amaç: Bu çalışmada, çeşitli nikel-titanyum döner tedavi sistemlerinin cerrahi olmayan endodontik tedavi sonrası postoperatif ağrının yoğunluğu üzerindeki etkisi karşılaştırıldı. Materyal ve metod: Endodontik tedavi gerektiren 180 hasta çalışmaya dahil edildi. Eski kanal dolgu materyalini çıkarmak için kullanılan yönteme göre hastalar rastgele 60 hastadan oluşan üç gruba ayrıldı. Grup 1'de, kanal dolgu dolgu materyali ProTaper Universal retreatment (PTUR) eğeleri kullanılarak uzaklaştırıldı. Grup 2'de, kanal dolgu materyali D-Race retreatment eğeleri ile uzaklaştırıldı. Grup 3'te, kanal dolgusunu uzaklaştırmak için Mtwo retreatment eğeleri kullanıldı. Daha sonra dişlere kalsiyum hidroksit uygulandı ve geçici dolgu materyali kullanılarak kapatıldı. Postoperatif ağrı varlığı 6, 12, 24, 36 ve 72 saat 7 gün sonra değerlendirildi. Bulgular: Üç grup arasında en yüksek postoperatif ağrı skorları işlemden 6 saat sonra kaydedildi; postoperatif ağrı skorları tüm zaman aralıklarında zamanla azaldı. 6 saat içinde Mtwo grubu D-RaCe grubuna göre daha yüksek ağrı skoru gösterdi (P <.05), ancak D-RaCe ve PTUR grubu arasında ve Mtwo ve PTUR arasında ağrı skorlarında fark yoktu (P> .05). Sonuç: Bu çalışmada test edilen retreatment sistemleri, cerrahi olmayan endodontik retreatment sonrasında 6 saat dışında benzer postoperatif ağrı düzeylerine neden olmuştur. Anahtar Kelimeler: Endodonti; kök kanal yenileme; postoperatif ağrı

Adjunctive procedure with solvent mixtures in non-surgical endodontic retreatment: does it affect root dentin hardness?

The aim of this study was to compare the effects of new irrigation solvent mixtures with Methyl ethyl ketone (MEK)/Tetrachloroethylene (TCE) and MEK/Orange oil (OOil), and different agitation techniques on dentin hardness. One hundred forty-four mandibular teeth were prepared and standardized, with each root's middle part transversely sectioned. Initial hardness was measured using a Vickers microhardness tester. Specimens were divided into four groups of agitation techniques (n = 36): no agitation; EndoActivator; IrriSafe; and XP-endo Finisher R. Each group was subdivided into six subgroups of irrigation protocols (n = 6): saline solution; NaOCl + EDTA; NaOCl + EDTA + MEK/TCE; MEK/TCE; NaOCl + EDTA + MEK/OOil; MEK/OOil. Final hardness was measured. The irrigation protocols NaOCl + EDTA, NaOCl + EDTA + MEK/TCE, and NaOCl + EDTA + MEK/OOil significantly decreased dentin hardness, while MEK/OOil increased it (p < 0.05). Comparing to NaOCl + EDTA sequence, dentin hardness increased significantly with the additional exposure to MEK/TCE (3%NaOCl + 17%EDTA + MEK/TCE) or MEK/OOil (3%NaOCl + 17%EDTA + MEK/OOil) (p < 0.05). There were no significant differences regarding agitation effects on dentin hardness decrease. The irrigation protocols affected dentin hardness significantly. However, the additional solvent proposals do not seem to address further concerns on dentin's mechanical properties. Agitation did not show any influence on dentin's hardness reduction.

Efficacy of Removing Thermafil and GuttaCore from Straight Root Canal Systems Using a Novel Non-Surgical Root Canal Re-Treatment System: A Micro-Computed Tomography Analysis.

The present study aims to evaluate the effectiveness of an XP-endo non-surgical root canal re-treatment system in removing both GuttaCore and Thermafil gutta-percha carrier-based root canal filling materials from straight root canal systems using micro-computed tomography (micro-CT) analysis. The study was performed on 20 single-rooted upper teeth, which were randomly allocated into the following study groups: Group A, Thermafil and AH Plus sealer (n = 10); Group B, GuttaCore and AH Plus sealer (n = 10). Before and after the non-surgical root canal re-treatment procedure, the samples were submitted for a micro-CT analysis. The volume of the root canal filling material (mm3), the volume of the remaining root canal filling material (mm3) and the time (minutes) needed to remove the root canal filling material were also recorded. Student’s t-test was used to analyze the results. No statistically significant differences were found between the volume of the remaining root canal filling material in the GuttaCore and Thermafil root canal filling systems at the coronal third (p = 0.782), middle third (p = 0.838) or apical third (p = 0.882) of the straight root canal systems; however, the GuttaCore required a statistically significant (p = 0.037) shorter amount of time (4.72 ± 0.76 min) to be removed than the Thermafil carrier-based root canal filling material (5.92 ± 1.42 min). The XP-endo Finisher non-surgical endodontic re-treatment system removes both GuttaCore and Thermafil gutta-percha carrier-based root canal filling materials from straight root canal systems, although removal of the GuttaCore gutta-percha carrier-based root canal filling material required less time.

Mandibular first molar root canal retreatment with the presence of a missed middle mesial root canal: a report of two cases

Aim: The purpose of the present case report is to document the root canal retreatment of two mandibular first molars with a previously unnoticed MMC. Summary: Mandibular molars may present a third root canal in the mesial root, defined as middle mesial root canal. This challenging anatomical variation should not be disregarded by the clinicians in order to minimize the possibility of an endodontic failure. This paper reports two cases of non-surgical endodontic retreatment of the mandibular first molar in which this complexity of the root canal system was missed in the first treatment, which may help to explain the treatment failure resulting in a periapical diagnosis of asymptomatic and symptomatic apical periodontitis in the first and second case, respectively. Key learning points: The use of magnification, with the dental operating microscope, and of ultrasonic tips was of the utmost importance in locating this additional root canal orifice. Both cases were able to achieve a successful outcome only after a correct chemical-mechanical disinfection and three-dimensional obturation of all identifiable anatomy.

Postoperative pain in endodontic retreatment of one visit versus multiple visits: a systematic review and meta-analysis of randomized controlled trials.

The aim of this systematic review and meta-analysis (SRM) was to assess the postoperative pain (PP) after non-surgical endodontic retreatment (NSER) in a one visit compared to multiple visits. The PICO question used was "Does NSER in patients with unsatisfactory endodontic treatment in a one-visit visit have a similar PP to that of NSER in multiple visits?" This systematic review followed PRISMA and was registered in PROSPERO (CRD42019136700). Searches were performed in the PubMed/MEDLINE, Scopus, and the Cochrane Library databases for articles published until September 2020. The eligible criteria were randomized clinical trials (RCTs). The meta-analysis was based on the Mantel-Haenszel. The PP after the retreatment was analyzed using a dichotomous outcome, measured according to risk ratio (RR) when p< 0.05. The Cochrane scale was used to assess risk of bias, and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach was used to assess the quality of evidence. Four studies were included. In general analysis without considering intensity, one-visit NSER presented lower PP than the multiple visits only for 1 and 30days [(RR = 0.67; CI: 0.48 to 0.93; p = 0.02), and (RR = 0.09; CI: 0.01 to 0.66; p = 0.02)], respectively. Regarding sub-analysis considering the intensity, one visit present lower mild PP when compared with multiple visits [(RR = 0.54; CI: 0.30, 0.96; p = 0.04); (RR = 0.33; CI: 0.12, 0.88; p = 0.03); and (RR = 0.12; CI: 0.02, 0.86; p = 0.03)], respectively. However, sub-analysis for moderate and severe PP showed no significant difference, independently of period evaluated (p> 0.05). Regarding the risk of bias analysis, a low risk was observed for most domains, except allocation that was considered unclear, while the certainty of evidence for each analysis was considered low. Within the limitations of study, the one and multiple visit can be considered adequate, because both present a similar occurrence of PP, except for mild pain. However, due to the low number of studies, further well conducted and standardized RCTs are needed to reassess these results. Both therapies of endodontic retreatment can be considered in clinical practice. Therefore, the endodontist must consider the patient's individual characteristics and experience to consider the best treatment approach.

Postoperative pain after nonsurgical endodontic retreatment: Hand files versus R-Endo rotary instruments

Postoperative pain after nonsurgical endodontic retreatment: Hand files versus R-Endo rotary instruments

Effect of three glass fiber post removal techniques on the amount of removed root dentin ''An in vitro study

Introduction: Glass fiber posts removal is a major obstacle in nonsurgical endodontic retreatment. The currently used removal techniques cause tooth structure loss in different amount. The aim of this study was to evaluate three glass fiber post removal techniques according to their effect on the amount of removed root dentin. Materials and Methods: Endodontic treatment was accomplished for 45 extracted single-rooted teeth. The teeth were decoronated and roots were cut apically at (11 mm) then fiber post spaces were prepared. Photographs of the apical cross-section for post space were taken using a camera at a magnification of 40. Fiber posts were cemented with dual cure resin cement. Then, the samples were divided into three groups (n = 15) depending on the fiber post removal technique: Group (I) DT post removal Kit, Group (II) ultrasonic tips E4D and Group (III) diamond bur and Peeso reamer. Posts were removed and images of the previous section were taken under the same magnification. AutoCAD program was used to compare the spaces difference between before and after removal images. Data were subjected to statistical analysis. Results: The average percentage of removed dentin was (1.89, 0.48, 0.09) cm2 in Groups I, II, and III, respectively. Group I showed the highest amount of removed dentin comparing to other groups, but no significant difference between Group II and Group III was recorded (P = 0.000). Conclusion: DT post removal kit group was the most aggressive technique for removing glass fiber.

Non-Surgical Endodontic Retreatment of Anterior Tooth with a Large Periapical Lesion and Extruded Guta Percha with 36 Months Follow-Up: A Case Report

Root canal treatment failure depends on many factors. Overfillings, insufficient fillings, missing canals, failure to provide a complete apical plug, and impermeability of coronal restoration are some of them. Failed root canal treatment may not always manifest itself immediately after treatment. Sometimes, root canal treatments, which have not been done well, can manifest themselves with extensive lesions and severe pain in the apical after a long time. Apical resection may be considered as a solution in lesions that are too large to be treated, but retreatment without surgery should be attempted beforehand. Thus, the patient may have recovered from unnecessary surgical procedures and treated with a more conservative method. This case presents the non-surgical retreatment of a left lateral tooth with a large periapical lesion with extruded gutta percha followed by a 36-month follow-up.

Using biodentine for non-surgical endodontic re-treatment of maxillary central incisor associated with severe external apical root: A case report with 2-years follow-up

A patient reported with pain and sinus opening in relation to a previously root canal treated maxillary central incisor. Intraoral radiograph revealed periapical radiolucency with shortening of root indicating external apical inflammatory root resorption associated with failed endodontic treatment. Nonsurgical re-treatment was started and intracanal calcium hydroxide (CaOH) was placed for four weeks. The tooth was obturated with Biodentine. At 6, 12, and 24 months follow-up, the patient was asymptomatic and radiograph revealed satisfactory healing. Inflammatory apical root resorption due to failed root canal treatment could compromise the root length and prognosis. Early arrest of such resorption is indicated by nonsurgical re-treatment using CaOH for root canal disinfection and obturating with bioactive material such as Biodentine, which results in the successful arrest of resorption and periapical healing.

Nonsurgical re-treatment of a twin-rooted maxillary lateral incisor

An accurate diagnosis of the anatomy of the root canal system is a prerequisite for successful endodontic treatment. Morphological variations or additional roots/root canal should always be expected. These variations should be strongly considered before starting any endodontic treatment using various diagnostic aids for better outcome therapy. Nonsurgical endodontic re-treatment of a painful twin-rooted maxillary lateral incisor tooth of a 40-year-old female was carried out due to improper diagnosis of the extra root. The clinical examination and radiographic analysis confirmed the diagnosis of previously treated/necrotic pulp and symptomatic apical periodontitis. The patient remained asymptomatic at 6-month follow-up both clinically and radiographically. The case report emphasized on the need for clinicians to be extra careful while treating such teeth and use of cone-beam computed tomography for their diagnosis and management.

Patients preference for endodontic retreatment or dental implant in failed endodontic treatment: A cross sectional study

This study aimed to investigate the preference of patients for management of teeth with failed endodontic treatment when considering its retention via non-surgical endodontic retreatment or extraction followed by dental implant. Self- administered validated questionnaire (pretest and post test) were given to 196 selected participants diagnosed with failed root canal treatment in the out patient department. The questionnaire ascertained their awareness about the treatment modalities (3 questions), preference for retaining their natural tooth (3 questions) and also whether the choice of treatment depends on the duration and cost of the treatment modality (4 questions). Data was collected and statistical analysis was done using Chi square test to determine level of significance. Participants’ preference for endodontic retreatment was significantly higher (92%, p value &amp;#60; .05) when compared to extraction and replacement with implant (8%). The cost effectiveness of endodontic retreatment significantly influenced the preference of the treatment (86%). Short duration of treatment plan with respect to endodontic retreatment was preferred by 14% participants. Also the long term prognosis of the treatment modalities influences the preference of the treatment. Participants preferred endodontic retreatment in order to retain their natural teeth. Explaining about the different treatment options should be done in an impartial manner as it can influence the preference of the treatment plan.