A statistical analysis of surgical and nonsurgical endodontic retreatment cases

Non-surgical management of endodontic failure - An observational study

“…The lack of appropriate canal shaping only increases the clinical difficulty of subsequent cleaning and obturation procedure 13 According to Washington study 3 broken instrument was the cause of failure in 1% cases, in this study broken instrument was the cause of failure in 4.34% cases. The highest affected teeth were the Mandibular first molars 27.53% in this study but in the study by Allen et al 3 the highest affected teeth were the Maxillary central incisors 19.20%. In this study retreated 30% teeth had no periapical lesion; In the present study 90% patients were available for follow-up, where as 10% patients were not available for follow-up.…”

“…Excessive overfilling were noted in 1.44% of teeth in this study, 4% of Washington 3 Study failure and 3% of the teeth evaluated by Hoen et al 11 and 12% of the teeth evaluated by Peterson et al 12 Incomplete obturation observed in the Washington study 3 was 59%, in Peterson study 12 50%, in Hoen study11 65%, and in present study poor obturation quality was seen in 81% cases. Over four-fifth of all of the endodontic failures in this study were related to inadequate performance of two points of the endodontic triad, "canal instrumentation and canal obturation".…”

“…When root canal treatment fails, decision has to be taken regarding the management; they may be the following -non-surgical re-treatment, surgical re-treatment or extraction. 3,4 According to survey by Buckley and Spangberg at the University of Connecticut, periradicular lesions found 8-10 times more often in endodontically treated teeth than for teeth without root fillings. 5 Most re-treatment can be eliminated however, if adherence to the principles of root canal treatment were carried out in every step of the initial procedure.…”

“…6 However, clinical surveys indicate that primary root canal therapy has a considerably higher success rate than subsequent attempt. 3 Non-surgical re-treatment is an endodontic procedure used to remove materials from the root canal space and if present, address deficiencies or repair defects that are pathologic or iatrogenic in origin, these disassembly and corrective procedure then allow the clinician to 3-D clean, shape and pack the root canal system. 1 Even with the vast improvement achieved in surgical endodontics in recent years, these techniques are restricted in their ability to eliminate pulp, bacteria and related irritants from root canal system.…”

Current strategy for successful periradicular surgery

“…The success rate for periradicular surgery is lower than that of root canal retreatment. Previous studies reported a success rate of between 50-90% for periradicular surgery, which is not higher than that for conventional root canal treatment (9)(10)(11)(12). Furthermore, any periradicular surgery will be of little value for teeth with poorly condensed filling or untreated root canals.…”