A percentage of endodontically treated teeth does not successfully respond to the therapy, developing an apical radiolucency after the intervention of the dentist.
In presence of symptoms or periapical infection in an endodontically treated tooth with a iatrogenic damage (i.e. perforations, stripping, ledges,disassembling), the dentist should think to the options he can give to the patient in order to solve the problem.
Once assessed that the tooth has no vertical fractures and can be restored, the choice is between non surgical retreatment and endodontic surgery. Both options have precise indications.
The clinician is supposed to know which is the best treatment, in order to give the patient the most suitable therapy. Non-surgical retreatment, in the last years, has broadened its field of employment and has remarkably increased its percentage of success. This is due to the new techniques and the novel equipment that help the dentist in solving complex clinical cases with multiple pathologies.
The objective of retreatment is to eliminate the obstacles that make challenging the complete shaping, cleaning and filling of the root canal system.
Thanks to ultrasonic tips and rotary dedicated instruments, emptying the root canal system is much easier, faster and safer than it was before. The cleaning action of the irrigating solution is extremely
improved by he action of US-activated files, guaranteeing a deeper disinfection of the root canal system.
The use of an operative microscope allows a better vision of the operative field, making possible to remove post, screws, to go beyond ledges and to repair perforations or stripping of the root.
The treatment of perforations has a better prognosis even thanks to the introduction of new biocompatible filling materials such as BIODENTINE or MTA, characterized by the property of setting in a moist environment and sealing the endodontic space.