Sometimes teeth that had a root canal treatment become re-infected, Failed Root Canal treatment or compromised which may require retreatment or sometimes extraction. Root canal failure can be caused for a different reason, after successful root canal retreatment, the tooth can be saved. The success rate of RCT, mainly depends upon 3 factors, it’s- 1) Proper Case Selection & proper treatment planning, 2) Dedication to the treatment procedure & 3) Proper Maintenance.
What is Root canal Treatment?
Root canal treatment or RCT is an Endodontic Dental treatment is performed to save a damaged or badly infected tooth to treat the infection or inflammation when the centre & inner part within the tooth, known as the pulp, portion the blood vessels, nerves and living connective tissues, peri-apical tooth structure become infected or inflamed. To know in details about Root canal treatment- CLICK HERE.
Common Indication of Root canal treatment (RCT):
- Deep dental caries or loss of the tooth structure when it reached to Pulp
- Infected or inflamed Pulp
- Infection to the inner part of the tooth, Connective tissue & supporting structure
- Perio-endo lesson
- Intentional RCT, Commonly for Prosthetic- Crown or Cap preparation.
- Tooth discolouration
Causes of Failed Root Canal Treatment :
- Poor oral hygiene & poor maintenance– After successful RCT treatment, proper maintenance is very important. Improper tooth maintenance can cause food impaction, gum disease, periodontal problem, loose tooth, caries, and pain. It can cause Perio-endo lesion, Failed Root Canal Treatment. Maintain proper Oral health for RCT success.
- Improper Tooth restoration– Improper tooth restoration
A) Inadequate interior seal & coronal seal of restoration material can cause leakage & infection.
B) Improper use of tooth restoration material
C) Overextension of the tooth’s filling material
D) Improper Root canal Treatment procedure
- Fractured tooth– A Root canal tooth can be easily fractured if is not restored properly or if the crown is not used or because of excessive trauma.
- Patient negligence
- Recurrent caries
- Bad case selection- Proper case selection is very important for a successful Root Canal treatment.
A) Grossly caries tooth: Grossly caries tooth, when minimal tooth structure is present then it can cause root canal failure.
B) Gum disease & Periodontal problem: When Gum disease is noticed then proper care is needed. If Periodontal problem & lose tooth is noticed then you shouldn’t get Root canal treatment, it can cause Failed Root Canal Treatment.
C) Abnormal tooth structure, tooth anatomy & Position: Proper tooth structure & tooth anatomy is important for successful root canal treatment. Branched canals-unfilled canals, Missed canals & abnormal canal structure can cause root canal failure. Personally, I avoid 3rd molar RCT.
D) Compromised patient: Some physically & Mentally Compromised patients- avoid RCT.
What is Perio-endo lesion?
This is an infection causes a lesion because of a tooth periodontal problem. This is the very common cause of Failed Root Canal treatment.
Sign & Symptoms of Failed Root Canal Treatment?
It can be diagnosed by clinical investigation & with the help of X-ray.
- Pain-localized or generalized & Swelling.
- Tenderness, sensitivity to percussion or on mastication
- Swelling, abscess or pus formation.
- With the help of x-ray, it can be easily diagnosed.
How is a Failing Root Canal Treatment treated?
The treatment plan will be depending on the tooth condition. Your dentist may advice surgically removing the apex of the tooth’s root instead of, or in addition to re-treating it. This procedure is known as an apicoectomy. The resulting hollow root tip may or may not require a special type of filling known as a retrograde filling.
a) Endodontic retreatment- Failed root canal cases frequently are retreated. A decision to proceed with this option would simply depend upon the tooth condition.
In most cases, retreating a tooth simply involves repeating the same procedure that was performed before at the time of RCT, with the exception that additional effort will be required to remove the previously placed canal sealing materials & again disinfect it then canal is filled with restoration material.
b) Tooth extraction and replacement- Besides retreatment, the other appropriate treatment choice for a tooth whose root canal work has failed is to extract it. This option might be chosen because retreating the tooth is not possible, or only offers a low probability of success.
What is Apicoectomy?
A root end surgery, also known as apicoectomy (apico- + –ectomy), root resection, retrograde root canal treatment or root-end filling, is an endodontic surgical procedure whereby a tooth’s root tip is removed and a root end cavity is prepared and filled with a biocompatible material.
Written by- Dr. Anuran Ghosh Mondal
Mob: +91 9432580313
Reference: https://en.wikipedia.org/, Thank you for the Reference