I am not sure that this is such a big debate from a treatment standpoint. The question is; “what should we do when root canal treatment has failed”. (JADA 2016:147(3):214-220). The truth is that every case is unique and the person who did the root canal treatment in the first place probably has the best idea about the logic of trying a retreatment procedure (doing the root canal over again). In some cases this may be a dollars and cents decision. In other cases this may be a “treatment desire” decision.

In most cases I am presented with, there is a logical thought process based on the clinical picture (what we can see is involved / what are the particulars for this patient) and what options are available to us. As a surgeon, even though we continue to perform surgical root canal treatments such as apicoectomy and retrofill, I have been moving away from these procedures in favor of implant treatment which in many cases is much more reliable and has a much higher success rate. So if I am presented with a failing root canal treatment, my prejudice is toward looking to another option.

I work closely with my endodontist colleagues and have found that there are obvious warning signs that would tend to guide us away from further root canal care (retreatment). To name a few; periodontally compromised teeth, suspicion of a periodontal communication, abscess along or close to the gum margin, fractured teeth, larger lesions such as odontogenic cysts, and a history of trauma. I would always encourage an opinion from the endodontist (root canal specialist) if there is any doubt.

If you have questions, call Wagner Oral Surgery and Dental Implant Specialists at (262) 634-4646 to learn more.