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Endodontic Retreatment

With the appropriate care, your teeth that have had root canal therapy will last as long as other natural teeth. Yet, a tooth that has received treatment may fail to heal. Sometimes pain may continue to exist, and may occur months or years after treatment. If so, Endodontic Retreatment may be needed.

Improper healing may be caused by:

  • Bacteria and diseased pulp tissue that could not be removed during the first treatment.
  • Complicated canals went undetected, or curved and narrow canals were not treated during the initial treatment.
  • The restoration or crown was not placed within the appropriate amount of time following the root canal procedure. Because of this, bacteria in saliva contaminated the root canal system.
  • An injury to the tooth.

In some cases, new problems can influence a tooth that was successfully treated:

  • New decay can expose the root canal filling material, causing infection.
  • A cracked or loose filling or crown can cause leakage into the tooth creating a new infection.

During retreatment, a rubber sheet is placed over your tooth. Dr. Lepore will then reopen your tooth and remove the restorative material to gain access to the root canal filling material. The inside of the canals will be cleaned and inspected. Once cleaned, he will fill and seal the canals and place a temporary filling in the tooth. You will then return to your dentist within a few weeks in order to have a new final restoration or crown placed to resume the tooth’s normal functions.


There are many surgical procedures that can be performed to save a tooth. The most common is called an apicoectomy, or root-end resection, which is occasionally needed when inflammation or infection persists in the bony area around the end of your tooth after a root canal procedure. In this microsurgical procedure, Dr. Lepore opens the gum tissue near the tooth to see the underlying bone and to remove any inflamed or infected tissue. The very end tip of the root is also removed. A small filling will be placed to seal the end of the root canal. A bone graft is used with platelet rich growth fibrin to assist healing. Over a period of months, the bone heals around the end of the root. Most patients return to their normal activities the next day. Postsurgical discomfort is generally mild.

Why would I need endodontic surgery?

In the majority of cases a root canal or retreatment is all that is needed to save your tooth from extraction. Occasionally, these non-surgical procedures may not be sufficient to heal your tooth and Dr. Lepore may recommend surgery. Endodontic surgery can be used to locate fractures or accessory canals that don’t appear on the x-ray but still manifest pain and infection. Often the end of the root has embedded bacteria in the root structure or branching of the canal(s) where it was untreatable. Damaged root surfaces or persistent infection in the bone area after a root canal treatment may also be treated with this procedure

Tooth Injuries from Traumatic Injurie Dislodged teeth

Injuries to the mouth can cause teeth to be forcefully moved in various directions. It can be pushed back in the socket or forced partially out of the socket in any direction. Do not delay in seeking treatment. Your general dentist may need to reposition and stabilize your tooth. Depending on the severity of the pulp damage from tooth movement or symptoms, root canal treatment may be necessary.

Cracked Teeth

Cracked teeth are becoming more common than ever before. People are living longer, and dentists are helping keep teeth live longer as well. That means teeth are being exposed to more years of chewing hard things, clenching and grinding. Fractures/cracks typically do not show on x-rays, making it more difficult to locate. Depending on the severity of the crack, symptoms may include a momentary sharp pain when chewing, temperature sensitivity, or even the release of biting pressure.

Why does a cracked tooth hurt?

Not all cracked teeth hurt. When it does, chewing can cause movement of the cracked pieces of our tooth, which irritates the pulp within the tooth. Pain upon release of biting pressure can occur because the crack closes quickly, resulting in a transient sharp pain. Repeated chewing irritates the pulp. Also, the depth of the crack can cause irritation and possibly degeneration to the pulp tissue. Eventually when the pulp becomes damaged the tooth may consistently hurt. The pain may include hot or cold sensitivity as well.

Can a cracked tooth be saved?

It depends on the location and depth of the crack, as well as your symptoms. Sometimes only a restoration or crown is needed. At times root canal therapy followed by crown placement is needed to remove the damaged pulp to restore the tooth to normal function. We are specially trained to treat cracked teeth, and utilize the endodontic microscope to assist in visualization.