Retreatment or radiographic monitoring of endodontics

By Van Nieuwenhuysen J, Aouar M, D'Hoore W.

Date: 07/1990
Journal: JOE

Summary: 

Purpose: to assess the outcome of retreatment and factors affecting the outcome.

N= 1032 root canals (612 retreated, 420 asymptomatic roots with RG evidence of inadequate endo)

Materials/Methods:

•Demographic data of patient was obtained, also assessment of initial root canal treatment ( table 1). Type of filling and isolation, iatrogenic errors, if intracanal medicament was used, type of filling and root filling technique was recorded.

•Some cases were retreated others were monitored radiographically without retreatment.

•Assessment of follow up RG: at 6 M,1,2 y (based on technical and healing assessments table 4, 5) carried out by 2 calibrated observers.

Most highlighted Results:

  • Mandibular molars were the most frequently retreated teeth (32.2%), particularly 1st molars.
  • 93% of the initial root fillings were unacceptable being judged either bad or questionable.
  • 34% of filling were improved by retreatment
  • Factors affecting the outcome of root canal retreatment: rubber dam isolation, root canal preparation and disinfection in the first visit, multiple visits, lateral condensation compared to single cone. Root filling within 1 mm from the apex. Retreatment was worst in cases with complication and retreatment worse than initial treatment .
  • Factors which affected the outcome of radiographic monitoring: absence of PA lesion was associated with better outcome.

Clinical Significance :

Retreatment is clearly indicated when a periapical radiolucency is accompanied by clinical signs and/or symptoms.