Worth it to re-treat a root canal molar a SECOND time? (photo)

Question

I have a molar (upper right, second from the back) that had a root canal in the 80s.That root canal failed in April 2012 and was addressed with a root canal retreatment from a referred endo. One week after, it abscessed and the endo phoned in antibiotics for me. 2 weeks ago, xrays show this tooth with a periapical abscess and sudden, constant throbbing pain. Again referred to an endo who wants to do a scan before final decision but is currently leaning toward re-treating the tooth.

Scott Young, DDS · Answer

This tooth has had an extensive amount of dental work and has abcessed again. It is very likely that the tooth has a fracture and an extraction will be necessary.  A dental implant may be an option to restore that tooth, but if not you can leave the space. Good luck.

Michael Tam, BDS · Answer

Although it isn’t as
common, it is quite possible to need to re-treat a root canal. Because you are
already seeing an endodontic specialist, you’re most likely getting the best
care possible for this type of condition. It may be that the tooth has a crack
somewhere, allowing bacteria to seep in. The other option would be to extract
the tooth altogether so as to prevent recurrent infection, then place a dental
implant in the area! At this point it can be a frustrating choice to make, but
it is a personal one and you’ll need to weigh your pros and cons to each to
determine what you personally want to do. With an implant, you won’t have to
risk a root canal retreatment in the future.

Charles Sutera, DMD · Answer

For a tooth to require retreatment of a root canal multiple times is quite rare but it does happen. If the tooth has good bone support and a crown with a good prognosis, it makes sense to attempt to save the tooth with another retreatment as long as the endodontist has a good sense of what is causing the infection based on the radiographs. Some common retreatment scenarios are: 1) There may be a rare auxillary nerve canal which may have been missed at the original treatments. This is particularly common in molars and the extra canal would need to be found and treated for the tooth to heal. 2) The nerve canals which were treated previously may have become reinfected for a variety of reasons and need to be recleaned. 3) There could be an infection or cyst at the tip of the root that is unable to fully heal. If this is the case it may be treated by a surgical retreatment technique known as an apicoectomy. 4) The tooth may have a hidden fracture in which case it wouldn't be saveable. Discuss with your dentist and endodontist, the expected prognosis of the tooth in comparison to other treatment alternatives, and make the best decision with all things considered.

Worth it to re-treat a root canal molar a SECOND time? (photo)

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Worth it to re-treat a root canal molar a SECOND time? (photo)

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Our mission is to create a world where every investment in modern beauty is Worth It.