title: Selective Root Retreatment: A Novel Approach.
abstract: Root canal retreatment is traditionally considered an "all or none" treatment approach. It is typically recommended that all restorative and obturation materials be removed from all roots regardless of the presence or absence of periapical pathosis. In contrast, surgical endodontics is not viewed as an "all or none" treatment approach. Traditionally, only the diseased root(s) is addressed via root-end resection and root-end filling. The use of cone-beam computed tomographic imaging allows for a more accurate evaluation of the periapical status of individual roots associated with multirooted teeth. This information has introduced a novel and conservative treatment alternative for previously endodontically treated teeth with multiple roots presenting with post-treatment disease. This new approach is termed selective root retreatment. Advanced imaging allows the clinician to make predictable treatment decisions with respect to the presence or absence of periapical pathosis of individual roots as opposed to making assumptions about the tooth as a whole. Selective root retreatment combines the approach of nonsurgical retreatment with the selectivity of surgical root resection. In this manner, retreatment could be limited to a single root or roots clearly showing periapical pathosis while leaving the root(s) with no visible or perceived pathosis untouched.
authors.affiliation: Private Practice, Specialized Endodontic Solutions, Bloomingdale, Illinois. Electronic address: nudera@comcast.net.
authors.forename: William J
authors.initials: WJ
authors.lastname: Nudera
mesh_terms: D054893:Cone-Beam Computed Tomography / Q000379:methods*; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D008875:Middle Aged; D010485:Periapical Periodontitis / Q000000981:diagnostic imaging / Q000628:therapy; D019233:Retreatment / Q000379:methods; D012390:Root Canal Therapy / Q000379:methods*; D025321:Surgery, Computer-Assisted / Q000379:methods*; D014070:Tooth / Q000000981:diagnostic imaging / Q000601:surgery
keywords: Cone-beam computed tomographic imaging; nonsurgical retreatment; selective root retreatment; surgical retreatment