Endodontic treatment options after unsuccessful initial root canal treatment: Alternatives to single-tooth implants

The Journal of the American Dental Association
Mahmoud Torabinejad, Shane N White

Abstract

Initial root canal treatment is highly successful, appreciated by patients, and cost-effective, but failures occur. Should a tooth with unsuccessful initial root canal treatment be treated by means of other endodontic procedures or be replaced by a single-tooth implant? Results from systematic reviews of the outcomes of nonsurgical retreatment, apical surgery, replantation, and autotransplantation show high tooth survival rates. Nonsurgical retreatment generally is prioritized before surgical endodontic treatment. Microsurgical endodontic treatment is superior to traditional surgical endodontic treatment and has high survival rates. Intentional replantation remains a viable alternative to extraction. Autotransplantation has a place, particularly in growing patients with an appropriate donor tooth. Single-tooth implants have higher survival rates, but the natural state has intrinsic value. The first-line treatment option after failure of initial root canal treatment is nonsurgical retreatment. Endodontic surgery, intentional replantation, and autotransplantation should be considered before extraction and replacement by a single-tooth implant. Comprehensive case assessment, evaluation of all endodontic options, and risk assessmen...Continue Reading

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Citations

Oct 28, 2017·Evidence-based Dentistry·Debra M Ferrailo, Analia Veitz-Keenan
Sep 26, 2020·International Endodontic Journal·A A AzimL Piasecki
Jan 26, 2021·Clinical Case Reports·Khaled Al-Manei, Kholod Khalil Al-Manei
Dec 23, 2021·European Journal of Dental Education : Official Journal of the Association for Dental Education in Europe·Jonathan LiewShalini Kanagasingam

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