Causes of Root Canal Treatment Failure
Placing permanent restoration (crowns) on the tooth immediately following the root canal treatment. Maintain the restoration with impeccable hygiene and regular dental check-up, it is a great way to save your tooth that can last a lifetime.
Many factors can lead to root canal failure, as the root canal system of your tooth can be complex. A root canal can become re-infected if the restoration has leaked, the patient failed to maintain good oral hygiene, or the tooth/sealing materials have degraded or broken down over time.
Many factors can lead to root canal failure, as the root canal system of your tooth can be complex. A root canal can become re-infected if the restoration has leaked, the patient failed to maintain good oral hygiene, or the tooth/sealing materials have degraded or broken down over time.
Cavities or gum disease can develop on a root canal treated tooth, just like any other natural tooth in your mouth. Brush and floss your teeth thoroughly and visit your dentist/dental hygienist for regular scaling to keep healthy gums.
Since the canals are sealed with root canal cement and Gutta Percha, there is no nerve in the tooth, the patient will not feel any symptoms if the tooth gets a cavity. The tooth will only hurt if it gets fractured (eg caused by trauma, grinding, etc) or gets another abscess around it. Root canal treatments do not wear out, however in about 5% to 15% of the cases, a root canal or endodontic treatment can fail. |
There is always a possibility of failure--things can go wrong during endodontic treatment that would not become apparent for a long time after the treatment is completed.
Front teeth have single roots and canals. They are easier to access and treat. Whereas back teeth have more roots and canals and are typically subjected to heavier biting force than the front teeth.
There is a significant correlation between aging and how resistant a tooth is to fracture. Teeth can become more brittle over time and have a greater tendency to develop cracks/fracture. The placement of the crown or other restoration was delayed following the treatment, resulting in bacterial re-infection of the root canals.
Front teeth have single roots and canals. They are easier to access and treat. Whereas back teeth have more roots and canals and are typically subjected to heavier biting force than the front teeth.
There is a significant correlation between aging and how resistant a tooth is to fracture. Teeth can become more brittle over time and have a greater tendency to develop cracks/fracture. The placement of the crown or other restoration was delayed following the treatment, resulting in bacterial re-infection of the root canals.
Undetected or accessory root canals
One of the most common reasons for failed endodontic treatment is that there is an extra canal in the tooth beyond what would normally be expected. Lower incisors, which are "supposed to" have only one canal, can have a second, hidden canal hidden behind the first one. Molars with three roots can have four canals. If the extra canal cannot be found, it can eventually become infected, resulting in a tooth abscess. There may also be an obstruction that prevents the dentist from cleaning the entire canal of your tooth. Narrow or curved root canals can pose complications. There can be extra canal branches, deep in the pulp system of a tooth, that can be difficult or even impossible to reach with a dentist's instruments. |
Occasionally, there can be a mishap during the endodontic treatment such as files that becomes lodged in the canal, or problems in getting the filing instruments around curves. Sometimes these files can be retrieved, but many times they cannot. In the process of instrumentation, ledges can develop that can make it very difficult to complete the treatment.
A root of the tooth can develop a crack, which makes it impossible to seal the canal and prevent infection from re-entering the tooth. Vertical root fractures often show minimal signs and symptoms and may therefore go unnoticed for some time and are discovered when the surrounding bone and gum become infected. Treatment may involve extraction of the tooth. Endodontic surgery is appropriate if the tooth can be saved by removal of the fractured root. |
Treating a failed root canal
For many of these problems, re-treating the tooth may solve it. The dentist can go into the tooth, remove the old endodontic filling material, and then re-fill it, getting a better seal the second time. The dentist can also send the patient to an endodontic specialist, who has special tools and techniques to deal with failed treatment. Other times, root canal surgery may be the answer. One type of surgery is an apicoectomy which involves accessing the root of the tooth through an incision made in the gums and bone. The tip of the root may be cut off and the area is cleaned and sealed from the end of the root. Sometimes, pain after a root canal can be difficult to diagnose and can be caused problems unrelated to the root canal treatment like gum problems, sinusitis, TMJ, pain from an adjacent tooth or heart attack. The chances for a successful treatment are always the best the first time it is treated. In the case of a failed root canal, the chance that a re-treatment or surgery will succeed is 50% to 75% at best, depending on what is wrong. Read more What is Root Canal Treatment? Why is Root Canal Treatment necessary? After Root Canal Treatment Aftercare Root Canal Treatment |