Re-treatment \ Repeat Root Canal Treatment
Root canal retreatment is required when the tooth in question has inadequate initial treatment with the symptoms of pain, swelling and sign of unhealed lesion at the apex of the root. Many root canal (Endodontic) failures can be attributed to complex root canal anatomy or inadequate training of the clinician, a lack of understanding of modern endodontic concepts and how to implement them. Retreatment therefore necessitates the use of specific techniques and often proves complex and difficult. Here the use of Operating Surgical Microscope becomes MANDATORY.
The patient came to the clinic with pain and swelling in the lower right premolar-molar region. On examination and RVG (radiograph), one could see incomplete root canal treatment in lower right 1st molar and lower right 2nd premolar with periapical lesion (inflammation, infection) was seen. When the crown of the molar was removed and the canals cleaned, a perforation on the pulpal floor made by the previous dentist could be seen. ProRoot MTA (Mineral Trioxide Aggregate from Dentsply) was placed in the perforation. MTA is a special root canal repair material to be used exclusively under the microscope. The root canal treatment of both the teeth was performed. The teeth were reinforced with cosmetic screw post followed by a core build up. On the teeth, the Porcelain fused to metal crowns were placed. Immediate improvement was seen. The pain disappeared and the size of the periapical lesion began to decrease. A year later after the retreatment, the tooth is totally asymptomatic and the periapical lesion has almost disappeared.