Decision-making for retreatment intervention in Endodontically treated teeth

Abstract

In Japan, the number of retreatment of endodontically treated teeth is relatively high. This indicates the low success rate of root canal treatment. Here, we will discuss the “decision-making process for retreatment of endodontically-treated teeth” according to Friedmanʼs decision tree (1986) and will discuss the six points of diversion in terms of treatment options. The six points are:(1) restorability, (2) evaluation of the apical surgical periodontium, (3) accessibility of the root canal, mainly in situations where surgical endodontic treatment should be considered, (4) the quality of the radiographic root canal filling, which does not necessarily mean the overall quality of the root canal treatment, (5) the need for a new prosthesis, and (6) consideration of treatment options if there is any: (a) when root canal treatment is not successful, and (b) when root canal treatment is successful but a new prosthesis is needed--with emphases on problems peculiar to Japan. I also discussed five options which are nonsurgical retreatment, surgical retreatment, tooth extraction, follow-up, and referral to a specialist.