The reason that Dr. Aruri would suggest a root canal treatment is if your cavity is deep enough to become infected and spread to the nerves in the root of your tooth. Left untreated, a cavity this deep can become an abscess and may even lead to bone loss in your jaw as well as other health problems. If you happen to have cracked or damaged teeth (where your tooth’s nerves are exposed) Dr. Aruri may also recommend a root canal.
For a variety of reasons, root canal treatment may occasionally be unsuccessful, at which point additional treatment becomes necessary. One purpose of an endodontist evaluation is to identify specific causes of a dental problem and determine whether or not they will be able to correct it. When evaluating teeth that have already had endodontic treatment, a 3-dimensional image (CBCT scan) is extremely useful.
One of the main reasons root canal treatment can fail is when all of the tooth’s canals were not identified and treated, or else were not completely cleaned. These are problems that can often be corrected with retreatment.
Another way treatment can become compromised is through leakage of salivary bacteria, which can contaminate the treatment area and lead to infection of the root canals and eventually the surrounding bone and gums. This leakage can either be the result of an ill-fitting crown or filling or else through new tooth decay. With poorly-sealed root canals, contamination will occur rapidly, unlike a well-sealed root canal, which effectively slows or prevents contamination and infection. This problem can also be corrected with retreatment in most cases.
Retreatment aims to achieve the same results as initial root canal treatment. Dr. Aruri will mechanically remove debris, tissue, and infection from within the canal spaces, then chemically disinfect those spaces, and finally seal them off with a root canal filling so that recontamination will not occur.
Before Dr. Aruri can do this, he must disassemble the existing restoration and previous root canal treatment, which can involve removing or making an access opening through the existing crown, or removing existing posts or cores. After disassembly is complete, he removes the previous filling material so that he can clean and disinfect all canal spaces. Sometimes, he will fill the canals with a temporary medication before completing treatment in a separate visit.
To complete the retreatment, Dr. Aruri seals the canals with a root filling. You may need to have a permanent restoration like a crown to be fabricated. A damaged or leaking restoration will need to be replaced, because a well-fitting final restoration is crucial for the treatment to succeed.