title: Endodontic treatment options after unsuccessful initial root canal treatment: Alternatives to single-tooth implants.
abstract: BACKGROUND
  Initial root canal treatment is highly successful, appreciated by patients, and cost-effective, but failures occur. Should a tooth with unsuccessful initial root canal treatment be treated by means of other endodontic procedures or be replaced by a single-tooth implant?
  
  
  RESULTS
  Results from systematic reviews of the outcomes of nonsurgical retreatment, apical surgery, replantation, and autotransplantation show high tooth survival rates. Nonsurgical retreatment generally is prioritized before surgical endodontic treatment. Microsurgical endodontic treatment is superior to traditional surgical endodontic treatment and has high survival rates. Intentional replantation remains a viable alternative to extraction. Autotransplantation has a place, particularly in growing patients with an appropriate donor tooth. Single-tooth implants have higher survival rates, but the natural state has intrinsic value.
  
  
  CONCLUSIONS
  The first-line treatment option after failure of initial root canal treatment is nonsurgical retreatment. Endodontic surgery, intentional replantation, and autotransplantation should be considered before extraction and replacement by a single-tooth implant.
  
  
  CONCLUSIONS
  Comprehensive case assessment, evaluation of all endodontic options, and risk assessment for caries and periodontal disease are always necessary when choosing the optimal treatment for a patient when initial root canal treatment has failed to heal.
authors.forename: Mahmoud
authors.initials: M
authors.lastname: Torabinejad
authors.forename: Shane N
authors.initials: SN
authors.lastname: White
mesh_terms: D019250:Dental Implants, Single-Tooth; D004708:Endodontics / Q000379:methods*; D006801:Humans; D012390:Root Canal Therapy / Q000009:adverse effects*; D014090:Tooth Replantation; D017211:Treatment Failure
keywords: Endodontically treated; autotransplantation; dental implant; endodontic surgery intentional replantation; outcome studies; retreatment; review