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Root Canals

Re-treat a root canal or apioectomy?



I am a 50 year old woman with good oral hygiene but bad dental genetics? Let me give you a little history on number 9 before I ask my question about number 24. 3 years ago I presented to the dentist with chronic pain on number 9 after having a crown replaced approximately 1 year previous. Eventually I was told that I needed a root canal which I am all to familiar with. The problem did not resolve. I was sent to another endodontist where my root canal was re-treated. After the problem was again not resolved, I had a series of two apioectomies. After that did not resolve, I was told that I probably had a small fracture in the tooth and it should be removed. The tooth was removed with no fracture present! I opted for an implant and 3 years later I am not a happy camper. I have had many problems and continued off intermittent pain. 1 year ago I had my braces removed which had been on for 2 years. The gums around my bottom incisors recessed quite a bit in those 2 years. Number 24 started to discolor about 1 year ago with off and on discomfort, which I was told may be from "moving"my teeth. As I said, my orthodontist removed my braces 1 year ago but continued to see me every month to try and "finish" straightening my bottom incisors with a retainer. He decided that it would be best to place 6 brackets on again for 1-2 months and then place a permanent wire behind those teeth. 1 week prior to this I saw my regular dentisr for a cleaning at which time she said I needed to see an endodontist for number 24. She saw some shadowing around the root canal and said that the treatment went too far down. I am sorry for the long history, but I thought it might be relevant. She is telling me that I will probably lose the tooth if I do not have a re-treat. My sister is a dental hygenist-I know, not a doctor :)-and she has suggested that I go straight for the apioectomy instead of the re-treat first. I am trying to watch my pennies and my dental insurance is not that great. I want the least amount of pain but I do not want to lose the tooth. I would not have the option for an implant this time around, both economically or emotionally! Any suggestions, would be greatly appreciated as I have seen many differnt people for the problem with number 9 over a long period of time. I am hoping to avoid this again. Thank you.


It sounds like your dentist recommended the retreatment. Have you seen your endodontist for an evaluation of the tooth yet? Your endodontist should be able to explain whether a retreatment or a surgery would be your best option. There are specific indications in each situation why one may be more successful than the other. You cannot decide which treatment is best based on a history of other teeth. The decision must be specific to the tooth in question and the endodontist evaluating you should be able to describe that in more detail.

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Response by:

Melissa McCartney Drum, DDS, MS Melissa McCartney Drum, DDS, MS
Assistant Professor of Endodontics
College of Dentistry
The Ohio State University