Endodontic Retreatment: A Clinician’s Perspective

Apical periodontitis remains a significant and often underestimated global burden. A comprehensive systematic review and meta-analysis by Tiburcio-Machado et al. (International Endodontic Journal, 2021) demonstrated that approximately 52% of adults worldwide present with at least one tooth affected by apical periodontitis, with nearly 39% of root-filled teeth exhibiting persistent disease. Complementing these findings, Jakovljević et al. (Journal of Endodontics, 2020) reported that 6.3% of teeth in the general population present with apical periodontitis and that more than 40% of endodontically treated teeth are affected, highlighting the strong association between disease prevalence and the quality of endodontic and restorative treatment. Together, these landmark studies confirm the increasing clinical relevance of endodontic retreatment in daily practice.
This focused lecture presents retreatment from a clinician’s perspective, emphasizing practical decision-making and predictability rather than comprehensive technique review. The session will address how to identify true etiological factors of post-treatment disease, establish clear indications for retreatment, and assess prognosis based on restorability, anatomical complexity, and strategic tooth value.
Clinical strategies will focus on simplified and efficient retreatment protocols, including access refinement, safe removal of existing filling materials, and negotiation of complex canal systems using contemporary NiTi instrumentation and enhanced irrigation. Risk assessment, management of procedural challenges, and communication of realistic outcomes will form an integral part of the discussion.
The aim of this lecture is to provide a concise, evidence-based and clinically applicable framework that supports confident retreatment decision-making and biologically driven management of previously treated teeth in everyday endodontic practice.