SP-34 Nonsurgical Retreatment: Clinical Management of Failures

CE Hours: 0.75

Description: Endodontic retreatment is carried out in cases where previous endodontic therapies failed. The main cause of treatment failure is bacterial persistence within the root canal or coronal leakage after treatment. Literature reports a success rate ranging from 80% to 88% for endodontic retreatment; thus, it is a procedure with a predictable prognosis when well performed. Prognosis will be affected by the type of previous treatment and anatomical alterations occurred during primary treatment. Numerous technologies such as operative microscope, CBCT, and ultrasound are available to help execute the different procedures that could demand this therapy. Overall, clinical procedures include: removal of pins or posts and other core materials; removal of guttapercha, silver cones, management of ledges, root perforations and in some cases, even separated instruments. The main objectives of this clinical lecture are to describe some of the most common clinical situations that occur during endodontic retreatment and to highlight the importance of this practice for tooth conservation.

Learning Objectives: 

• Recognize the importance of diagnosis and evaluate the causes of primary treatment failure
• Perform safe and predictable protocols to approach the different difficulties that a retreatment case may present
• Describe the available technologies such as operative microscope, CBCT and ultrasound for the management of retreatment cases