Reendodontia: what is it and what is it for?

After a root canal, things may not turn out as you expected. For these cases, there is re-endodontia, a second chance for teeth.

Last update: October 10, 2021

As in any dental procedure, the results of a root canal may not be what you expected. For those situations in which a tooth that has already been operated on returns to present pain or infection, there is re-endodontia.

With proper care, teeth that have undergone root canal treatment can last a lifetime. But there are situations that can lead to the failure of therapy or the appearance of symptoms, even several years after the procedure has been performed.

Reendodontia It is a second chance for those teeth that have already received a root canal treatment.. We tell you in more detail what this dental procedure is about.

What is a root canal?

Endodontics or root canal treatment is a dental practice that It is used to solve conditions that occur in the innermost part of the teeth. When the pulp is inflamed, necrotic or infected, the situation can be remedied without the need to extract the tooth.

Root canals consist of removing the damaged pulp tissue and cleaning the interior of the tooth. The remaining space is filled with biocompatible materials that allow the ducts to be sealed.

The pulp of the teeth is the soft tissue that is inside, covering both the root and the crown. In its thickness are the blood vessels and nerve fillets, so his condition generates symptoms in the patient.

Pulp injuries can be caused by deep and advanced caries, trauma or pathologies of the tissues that surround the tooth. Also for old fillings, poorly made or leaked.

A patient is likely to need root canal treatment when they have any of the following symptoms:

  • Sensitivity cold and hot.
  • Pain on the affected tooth or in neighboring areas. The discomfort can be constant, throbbing, intermittent, when biting and with different intensities.
  • Color change of the tooth crown.
  • Appearance of an abscess or fistula.
  • Swelling on the gum, neck or face.

When any of these symptoms appear, the ideal is to consult the dentist. Finding an immediate solution prevents the process from progressing and complicating.

Risks of endodontics

After you have had a root canal, the patient may have pain or discomfort for a few days. But in general they calm down with the medication and care indicated by the dentist as part of the postoperative period.

The patient can return to their daily activities the day after the intervention. You should be careful not to chew with the treated piece until its final repair is made.

After the intervention, some subsequent dental check-ups will be necessary. X-rays will be taken to evaluate the tissues surrounding the treatment and, if there is no discomfort, a permanent filling or a crown can be placed to restore the tooth’s shape.

But as we already anticipated, the root canal treatment may not turn out as expected. Many times the pain does not go away or it becomes more severe. Abscesses can also develop around the tooth root.

Symptoms indicating treatment failure may appear immediately or after several months. And even years after the intervention was performed. It is in these cases when The alternative of performing a re-endodontia to preserve the element or to extract the piece and lose it should be evaluated.

Signs of root canal failure can appear up to years after the initial approach.

What is a re-endodontia?

Rendodontia is a root canal retreatment, that is, perform a root canal again when the first intervention has not worked as expected. This procedure is applied in those cases in which there was already a root canal treatment, but for some reason it failed.

It consists of removing the materials that had been placed inside the root canals and re-cleaning, shaping and filling the interior of the tooth. The main objective of this procedure is to keep the tooth in the mouth and avoid its extraction.

Steps of re-endodontia

Before proceeding to perform a re-endodontics, the dentist must evaluate whether it is possible to perform the technique on the affected tooth. Many times, the damage is too severe, compromises other structures, or the dental remnant is so scarce that it will be impossible to rehabilitate.

If it is decided that re-endodontia is feasible, the endodontist will follow these steps to redo the treatment:

  1. Anesthesia: Local anesthesia is placed in the area to be intervened, although it may not be necessary in some cases.
  2. Access the conduits: With rotary instruments, a perforation is made that allows access to the area of ​​the ducts. If the tooth had already been restored with crowns or pins and crowns, they must be removed.
  3. Remove the filler material: The canals that had been filled must be accessed and all the material present inside the tooth must be removed.
  4. Cleaning the ducts: the canals are re-cleaned and shaped with rotary and manual instruments and washing with special liquids that allow to remove residues and disinfect the interior of the roots. One must carefully examine and look for the presence of any additional channels that have been missed in the previous intervention to treat it.
  5. Duct sealing: When the ducts are clean and dry, they are filled again with a biocompatible material until the cavity is sealed.
  6. Restoration of the dental element: the tooth is protected with a temporary or definitive restoration that restores the dental anatomy, depending on the clinical case.

During the procedure, the use of dental radiographs will be necessary to evaluate the working length, the morphology of the canals and the adequate sealing. Many times it is necessary to carry out the therapy in several sessions or to combine re-endodontics with endodontic surgery.

Subsequent controls will be necessary to evaluate the evolution of the patient and his response to the new treatment.

In which cases is a rendodontia indicated

We have already mentioned that re-endodontia is indicated in those cases in which a previous root canal treatment has failed. Here are some situations that may have led to the first attempt not having the expected results. They are as follows:

  • Incomplete removal of pulp tissue.
  • Persistence of microorganisms after treatment.
  • Incomplete filling of the ducts, leaving empty areas.
  • Presence of curved, narrow or inaccessible canals that were not treated in the initial approach.
  • Complication in the anatomy of the canal that was not detected in the first root canal.
  • New cavities.
  • Delay in placing the crown or final restoration.
  • Filtration of the restoration. Saliva contacts the inside of the tooth.
  • Loss or breakage of the crown or filling. When treatment coverage is removed, the tooth is exposed to salivary contact or a new infection.
  • Tooth fracture.
The presence of a new caries warrants a re-endodontia.

Symptoms that indicate the need for a re-endodontia

A dental element with a root canal treatment is considered without vitality, because it no longer has pulp tissue inside. As you have no feeling nerves, you should not have any symptoms or sensations.

But there are cases in which the patient goes to the dentist presenting discomfort that could indicate the need to do the endodontics again. Here are some of the symptoms that would signal that something is not right with root canal treatment:

  • Pain: that has appeared, has remained, or has worsened since the treatment was performed. It can be spontaneous or appears when biting.
  • Swelling of the face, neck or gums.
  • Sensitivity cold, heat, percussion or palpation.
  • Presence of fistula.
  • Active cavities.
  • Faulty restorations, broken, loose or missing.
  • When taking an X-ray they are observed canals that have not been treated in the previous root canal or they are poorly sealed.
  • Apical lesions are seen on radiographs that did not exist before doing the treatment.

What are rendodontics for?

As we have already mentioned, re-endodontics allow reoperation of a tooth in which a previous root canal treatment has failed. In this way, the person’s tooth can be kept in the mouth without the need to remove it or subject it to apical surgeries.

This procedure offers us the possibility of saving the tooth from extraction. It is that the only alternative to a root canal retreat would be to remove the problem tooth from the mouth.

In these cases, the absence of the extracted element should be replaced by an implant, a bridge or a prosthesis that allows the patient to chew and speak normally. In addition to giving the smile an aesthetic appearance and avoiding the movement of the adjacent teeth.

Although advances in oral rehabilitation allow good results to be obtained, there is nothing like a natural tooth in the mouth. For this reason, resorting to re-endodontics is a possibility to keep the dental element itself in the oral cavity, fulfilling its normal functions.

Taking care of treatments

Root canal treatments They allow to solve affections that occur inside the teeth. Most of the time the results are positive and the patient can return to his daily life without any problem.

But now you know that some situations can make the first attempt at treatment fail and annoying symptoms appear. Re-endodontics is an alternative to solve the failures or complications of a previous endodontics.

Going to a good endodontist can reduce the risk of failure caused by errors in technique. However, whether it is a first root canal treatment or its retreatment, patient care is also very important.

Having good oral hygiene habits, such as brushing your teeth three times a day and flossing regularly, can make a difference. Going to the dentist for the scheduled check-ups and not postponing the final restoration is also essential.

With a good professional in charge and proper care at home, the chances of success of a root canal are greater. And if something doesn’t go as expected, you know what re-endodontics is a good alternative before losing your own tooth.

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