Gangdong-gu Retreatment of Root Canal Therapy: Why Is the Success Rate Lower Than the First Treatment?

강동구 재신경치료, 왜 첫 치료보다 성공률이 낮다고 할까요?

Hello.

I am the director of Seoul Bardi Dental Clinic.

When a tooth that has already finished root canal treatment starts hurting again, it can be very confusing.

After hearing that retreatment has a lower success rate, many patients come in wondering whether it might be better to

just have the tooth extracted and get an implant instead, so they can feel more at ease.

However, no matter how advanced the technology becomes, it is difficult for an implant to fully replace

the unique functions of a natural tooth.

Today, I’ll explain in detail how we saved an incisor with severe root inflammation that had caused the surrounding jawbone to dissolve,

through retreatment of root canal therapy.

Why is retreatment difficult? Gangdong-gu Retreatment of Root Canal Therapy: Why Is the Success Rate Lower Than the First Treatment?

The process of treating a tooth that has already undergone root canal therapy again

is less successful and more complicated than the first treatment.

There are several medical reasons for this.

1. Removal of the existing filling material

The rubber material previously placed inside the root canal must be completely removed.

The very process of carefully scraping away the material that is tightly adhered to the canal walls

is a major challenge and takes a lot of time.

2. Increased bacterial resistance

The biofilm formed by bacteria that have already survived does not easily respond to ordinary disinfectants.

To firmly control the inflammation, a much more repeated and detailed disinfection process is essential.

3. Calcified root canals

Over time, the root canal often becomes narrowed or calcified.

Regaining the tiny, invisible pathway and accurately reaching all the way to the root tip requires very delicate technique.

Retreatment, Why it should still be attempted even if the success rate is lower Gangdong-gu Retreatment of Root Canal Therapy: Why Is the Success Rate Lower Than the First Treatment?

According to the literature, the success rate of the first root canal treatment is very high, at over 90%.

However, when inflammation recurs and retreatment is performed, the success rate can drop to below 70%.

Even so, why do we still try to save natural teeth?

Although implants are an excellent alternative,

because they do not have the cushioning tissue called the periodontal ligament, like natural teeth do,

they cannot fully convey the subtle sensations felt when chewing food.

Patient case: An incisor damaged by root inflammation Gangdong-gu Retreatment of Root Canal Therapy: Why Is the Success Rate Lower Than the First Treatment?

Recently, a patient came to our clinic complaining of pain in the left front tooth.

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After examining the CT scan, the condition was quite serious.

The inflammation at the root tip of the left incisor (#22) had grown so large that it had melted away most of the surrounding jawbone.

Can you see the especially dark area in the image, which looks like an empty space?

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That area is where inflammation had become deeply established, causing the bone to dissolve.

This inflammatory pocket had also invaded and been dissolving the bone of the adjacent tooth (#23).ㅜㅜ

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The tooth was not severely loose, but based on the size of the inflammation alone,

it was exactly the kind of case where extraction and an implant would be recommended.

Nevertheless, why we chose retreatment of root canal therapy Gangdong-gu Retreatment of Root Canal Therapy: Why Is the Success Rate Lower Than the First Treatment?

Even though the inflammation was this large and a lot of the surrounding bone had been dissolved,

why did we choose retreatment instead of an implant?

No matter how much implant technology has improved,

it is still difficult to perfectly replace the unique sensation and comfort of one’s own tooth.

After carefully examining the cause,

we found that the problem was that the material placed during the previous treatment had not been filled all the way to the end of the root canal.

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Bacteria multiplied through those tiny gaps, causing the inflammation to grow out of control.

To save the patient’s precious front tooth, we began retreatment of root canal therapy.

The first thing that had to be done was to completely and cleanly remove the old materials that had been placed during the previous treatment.

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Only by completely clearing out the contaminated area can a new pathway be found.

Do you know what the most important point in this treatment was?

It was to precisely identify the length of the root canal all the way to the root tip.

Only by accurately finding the full length of the root canal can we prevent bacteria from multiplying again,

and clearly prevent the kind of suffering caused by inflammation that happened this time.

It is one of the most basic yet important steps in root canal treatment.

Normally, root canal disinfection is performed about 2 to 3 times,

but because this patient’s pain continued and the inflammation was so extensive,

we carried out the disinfection process very carefully over a total of 10 sessions.

As a dentist, even if it is a little more inconvenient and takes more time,

I believe it is a process we should gladly accept if it means we can save the tooth.^^

Treatment result: Jawbone filling back in Gangdong-gu Retreatment of Root Canal Therapy: Why Is the Success Rate Lower Than the First Treatment?

After the ten disinfection sessions were completed, we took another photo.

How had the dark, empty space changed?

231129 (Before) 240215 (After)

Remarkably, the inflamed area that had looked like a hole

had now almost completely recovered, and we could confirm that the bone had filled back in firmly.

231129 (Before) 240215 (After)

The patient’s symptoms also improved a lot, so we completed the root canal treatment.

After carefully filling the cleaned root canal with biocompatible material,

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we placed a zirconia crown and completed the treatment. ^^

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You may be worried that you will have to have the tooth extracted because of pain that returns after root canal treatment.

Even if the process is a little difficult, with precise diagnosis and sincere care,

there is definitely a way to preserve your precious natural tooth.

Why not look together for the last chance to save your tooth?

We will think through the most appropriate path with you.

Thank you.

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Gangdong-gu Retreatment of Root Canal Therapy: Why Is the Success Rate Lower Than the First Treatment?

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| This post was written directly by Seoul Bardi Dental Clinic for the purpose of providing medical information in compliance with Article 56, Paragraph 1 of the Medical Advertising Act. We recommend that the information provided be used for reference only, and that symptoms and accurate management methods be explained by medical professionals after visiting a medical institution. All procedures/surgeries performed at the dental clinic may involve risks depending on the individual (inflammation, bleeding, swelling, etc.). Please decide after sufficient consultation with medical staff in advance. The treatment cases in this post were photographed with the consent of the actual patients who completed treatment at our clinic, and the before-and-after photos were taken under the same conditions. |