Continued from page 1 To attempt a retreatment, you should have confidence regarding the cause of failure and the belief that retreatment can successfully correct the deficiency. Remember that non-surgical treatment is one alternative among several options. If the patient is asymptomatic in spite of the pathologic condition, you can choose to either simply observe or treat. But remember that such asymptomatic cases have a high incidence of inopportune flare-up and delayed treatment often makes the eventual retreatment more problematic. If retreatment is chosen, the options are:
- - non-surgical retreatment,
- - surgical retreatment,
- - a combination of both, or
- - extraction
Observing questionable endodontic therapy that appears to be successful is considered acceptable treatment, but is not advised if the treated tooth is to receive a new restoration or is to be included as a critical abutment in a comprehensive reconstruction.
Some contraindications of conventional (orthograde) retreatment:
- - Sclerotic root canal which cannot be negotiated.
- - Thin canal wall leading to a risk of lateral perforation.
- - Root fracture.
- - Zipping at the apical part of the canal, with or without perforation.
- - Posts or broken instruments which are not amenable to removal.
- - Tooth not savable from the periodontal or restorative viewpoint.
- - Other general factors, such as patient’s OH status, medical conditions and attitude toward the treatment.
- P erforation
- O bturation incomplete
- O cclusal trauma
- R oot canal missed
- P eriodontal disease
- A djacent tooth
- S plit tooth
- T umor
- A natomic defect
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