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Revision – repetition of a failed root canal treatment

If complaints occur following root canal treatment, a revision may be the right step. During the surgical procedure, another attempt is made to clean the root canal of bacteria and foreign bodies and thus achieve a definitive coronal restoration of the tooth, i.e., a bacterial seal that is as stable as it is complete.

What is a revision?

The term revision, which comes from Latin, can be translated as looking at again. If the original root canal treatment of the tooth could not bring about the desired healing process of the tooth and its surroundings (the periodontal structures), this will be noticeable after a short time by recurring pain, and a new treatment is necessary. If the removal of the diseased pulp has not worked, which is checked again by an X-ray, a revision is considered. The root canal system may be re-infected by bacteria that have been able to penetrate the root canals again, whether due to caries or a leaking filling, or because the root canal system has not been sufficiently cleaned of these bacteria or cannot be cleaned due to its angled architecture. Accordingly, the treatment must be performed again, whereby the old root filling is completely removed and the canal system is cleaned. The final step is the filling and sealing of the tooth, the aim of which is a permanently germ-free and bacteria-proof closure of the root canal system.

The implementation of the procedure

In any case, the revision takes more time than the original root canal treatment. Not only must the previously performed root canal filling be removed, but the inspection of the canal system for unconsidered angles and foci of inflammation or foreign bodies is also time-consuming. For this purpose, the canals must be mechanically widened in order to remove the diseased dentin near the canal wall and to obtain the best possible access for cleaning or to be able to examine and fill previously hidden canals. After a temporary denture has been fitted, the first appointment is thus completed. Only after the desired result has been achieved can the root-treated tooth serve as a basis for further dental restorations, such as a crown. The probability of success of the procedure is between 60 and 85%. Of course, we will inform you in detail about the possibilities and risks before the procedure in order to meet your individual case.

Further complications and alternative treatments

If bleeding has occurred in the tooth during treatment - this procedure is absolutely harmless from a health point of view - the affected tooth can be whitened again and thus integrated into the overall appearance of your smile. If, on the other hand, revision cannot save the tooth either, root tip resection is to be resorted to. The same procedure should be performed if a cyst has formed on the root or a fracture has occurred prior to the revision. In both cases, the aim is to preserve as much of the natural tooth structure as possible.

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