Re-endo, or canal re-treatment, why it is worth doing it under a microscope

Is it possible to treat a tooth with a root canal a second time?

Root canal treatment is one of the most advanced and complex procedures in dentistry. However, the first treatment does not always bring the expected results, and then a repeated root canal treatment, also called retreatment, becomes necessary. Although it is a demanding process and often more complicated than primary root canal treatment, the development of dental technologies and techniques, such as treatment under a microscope, greatly increases its effectiveness. Using an endodontic microscope, the dentist has the opportunity to examine the inside of the tooth more closely, which is crucial, especially in cases where the first treatment did not bring the expected results. With a microscope, it is possible to identify and remove the remnants of pulp or old filling material that may have been missed during the first treatment. In what situations is the procedure of root canal treatment under a microscope most indicated? Why is retreatment under a microscope the most effective?

Indications for repeated root canal treatment

Repeated root canal treatment, also known as reendodontics, is a procedure that may be necessary when the original root canal treatment has not produced the expected results or when the teeth begin to cause problems again some time after the original treatment. Here are some of the most common indications for repeated root canal treatment:

• Infection or recurrence of infection — If bacteria enter the tooth canal after the original root canal treatment, reinfection may occur. The reason may be, for example, not removing all bacteria during the first treatment or reinfection due to problems with the crown seal or filling.
• Undetected or untreated dental canals — Teeth have a complex structure with several canals that can be difficult to see or access during the first treatment. If any of the channels is not cleaned and filled, this can lead to reinfection.
• Fractures of the crown or root of the tooth — fractures can allow bacteria to enter the internal structures of the tooth, leading to infection. In this case, repeated root canal treatment may be required.
• Loss or damage to the filling or crown—If the filling or crown is damaged or lost, bacteria can re-enter the inside of the tooth, leading to infection.
• Relapse of pain or discomfort — if the patient experiences pain or discomfort some time after the original root canal treatment, this may mean that the treatment was not fully effective.

It should be noted that the decision to perform a repeated root canal treatment should always be made after a thorough examination of the problem by a specialist.

What is root canal re-treatment?

Root canal treatment, or reendodontics, involves re-accessing the internal structure of the tooth, cleaning the root canals, removing old filling materials, and disinfecting and refilling the canals.

Below is the basic flow of the process:

1. In order to provide comfort to the patient, the dentist usually begins by administering local anaesthesia.
2. The dentist then makes a hole in the crown of the tooth to access the inside of the tooth.
3. The dentist uses special tools to remove the old material that fills the tooth canals.
4. After removing the old filling material, the channels are cleaned again to remove any residual bacteria and dead tissue.
5. After cleaning, the channels are disinfected, often using antibacterial agents or ozone, to destroy any bacteria that may remain.
6. When the channels are clean and free of bacteria, they are refilled. The most commonly used for this purpose is gutta-perka, a filling material that is moulded in the shape of the tooth canals.
7. After filling the canals, the tooth is rebuilt with a filling or crown to ensure its structural integrity and prevent future infections.

Root canal re-treatment is a technically difficult and time-consuming procedure, often requiring more time and dental appointments than primary root canal treatment. The success of such treatment depends on many factors, including the degree of infection, the number of canals in the tooth, the availability of canals, and the skill and experience of the dentist.

How long does it take to re-root canal treatment? How many visits will it take?

The duration of repeated root canal treatment can vary greatly depending on a number of factors, such as the degree of complication of the case, the number of canals in the tooth that need to be treated, and whether there are any complications such as infection or fractures.

In general, repeated root canal treatment may require 1 to 3 visits to the dentist. Each visit can last from 1 to 2 hours. Often, repeated root canal treatment is more time-consuming than primary root canal treatment because removing old filling material and cleaning the canals can be difficult and require additional time.

However, the final length of the process will depend on the specific circumstances of each patient and will have to be determined by the attending physician.

Does repeated root canal treatment hurt?

Repeated root canal treatment, like the first root canal treatment, is usually performed under local anaesthesia, which means that the area that is being treated is anaesthetised and the patient should not feel pain during the procedure.

However, after the procedure is completed and the anaesthesia has subsided, some patients may experience some degree of discomfort or pain. This is completely normal and is due to the healing process and the body's response to treatment. This discomfort can usually be controlled with the help of common over-the-counter pain medications, such as ibuprofen or paracetamol.

The extent of discomfort after surgery may vary depending on individual pain tolerance, the complexity of the case, and how well the patient adheres to postoperative recommendations. If the pain is severe or persists for several days, the patient should contact his dentist.

In general, although repeated root canal treatment may cause some degree of concern in patients, treatment-related pain is usually well controlled and can be easily managed.

Why is it worth doing retreatment under a microscope?

The use of a microscope in endodontics, especially during reendodontics (re-root canal treatment), has many advantages. The endodontic microscope allows for increasing the accuracy and effectiveness of the procedure due to better vision of the operating field. Here is a summary of the main benefits of using a microscope during root canal retreatment:

• Improved Visibility — The endodontic microscope increases the visibility of the treatment area, allowing dentists to detect details that could be missed by the naked eye. This may include additional root canals, imperceptible cracks, or remnants of old filling material.
• Increased precision — with better magnification, the dentist can better control the process of removing old fillings, cleaning the canals and filling them again, leading to a more accurate and effective treatment.
• Less risk of damage — the microscope allows the procedure to be carried out accurately, minimising the risk of accidental damage to other structures of the tooth.
• Increased chances of success—in general, increased accuracy and precision translate into better chances of successful repeat root canal treatment.
• Patient comfort — precise, focused treatment can reduce the time needed for the procedure and potentially reduce discomfort after the procedure.

In conclusion, the use of a microscope in repeated root canal treatment allows for greater precision and effectiveness of the procedure, increases the chances of its success and can improve the patient experience.

Reendo or implant

The decision between repeated root canal treatment (reendodontics) and tooth implantation can be complicated and depends on a number of factors that should be considered individually for each patient.

Tooth condition

If the tooth is severely damaged or infected, but the root structure is still solid, re-endodontics can be an effective way to preserve the tooth. This procedure consists of removing infected or dead tooth pulp, cleaning the canals, disinfecting and finally filling and sealing the canals. However, in the event that the tooth is so damaged that it cannot be effectively saved with root canal treatment, an implant may be a better option. A tooth implant is an artificial tooth that is surgically implanted in place of a missing or removed tooth.

Costs

Reendodontics is usually cheaper to start with than an implant. However, if the procedure does not have the expected effect and subsequent treatment is necessary, the costs may increase. Implants are more expensive in the beginning, but they are very durable and rarely require further treatment, which can make them more economical in the long run.

time

Reendodontics usually require less time to heal and heal better than an implant. The process of implantation of the implant can take several months, which includes the time from the extraction of the tooth, through the healing of the extraction site, to the placement of the implant and crown.

General health

Certain health conditions, such as gum disease, diabetes, or autoimmune diseases, can affect the body's ability to heal after an implant is implanted. In these cases, reendodontics may be a safer option.

Patient preferences

The final choice between reendodontics and implants often comes down to the patient's preferences. Some people may prefer to preserve their natural tooth if possible, while others may choose an implant for a variety of reasons, such as long-term durability.

In summary, the choice between reendodontics and dental implants depends on a number of factors that should be considered individually for each patient.