Healing of Periapical Lesions - Repeat Endodontic Therapy

Repeat Endodontic Therapy

For retreatment of a non-healing lesion, there is really no magical method that can be employed; the course of action is merely to achieve what was supposed to have been achieved the first time. Keeping in mind the notion that endodontic retreatment is a problem-solving exploit will substantially increase its success.

After endodontic therapy has been executed, or re-executed, successfully, and the canals can no longer provide a nutrient-rich habitat for microbes, the issue of bone healing comes into focus. Ostensibly, then, for regeneration to occur, the root canal system must have been decontaminated and further access to microbial invasion must be prohibited. Regeneration of the bone has been demonstrated to occur, on average, at a rate of 3.2 mm² per month, and studies suggest that 71% of lesions have achieved complete resolution one year post-operatively.

Situations in which a surgical form of retreatment had been selected and in which apical resolution has still not occurred may still benefit from additional surgical intervention. Comparison of the outcome of periradicular surgery in teeth that had previously undergone surgical treatment versus teeth that were undergoing a surgical procedure for the first time. After 5 years, 86% of resurgically retreated healed with complete bone filling of the surgical cavity while only 59% of surgically retreated healed with complete bone filling. It has thus been demonstrates that surgical retreatment of teeth previously treated with surgery is a valid alternative to extraction.