Many patients are surprised: why is root canal treatment necessary if the tooth has been treated before and the “nerve” was removed? Unfortunately, standard protocols of the past did not always guarantee a 100% result. Today, treating dental canals with a microscope allows us to save even those teeth that 10 years ago would have been extracted.
Why do canals need to be retreated?
The main reason pain “returns” to a dead tooth is an infection that remained or re-entered the root canal system. This happens in several cases:
- Missed anatomy: A tooth may have 4 or 5 canals instead of 3. Without magnification, a doctor simply cannot see them.
- Incomplete filling: If the canal was not filled to the very apex, bacteria multiply in the empty spaces.
- Secondary caries: If a crown or filling was not hermetically sealed, secondary caries develops beneath them, eventually opening a path for infection deep into the root.
- Complex anatomy: Severe curves, narrowing, or the presence of instrument fragments from previous treatment.
Advantages of Dental Treatment Under a Microscope
A microscope in the hands of an endodontist is not just a trend, but a powerful precision tool. Modern optics provide 20-30x magnification and powerful directed light.
- Gentle preparation: The doctor sees the boundary between healthy and infected tissue, removing only what is necessary.
- Micro-crack detection: The microscope allows for seeing root cracks at an early stage when the tooth can still be saved (or, conversely, stopping hopeless treatment in time).
- Working with instrument fragments: Under magnification, a doctor can carefully bypass or remove an old instrument without damaging the root wall.
- Ideal cleaning: The microscope significantly increases control over the cleaning and processing of the canals.
How does the retreatment process work?
Root canal treatment in a “revision” format is a meticulous process and usually takes 1.5–2 hours.
- Isolation (rubber dam) — The tooth is separated by a latex barrier so that saliva does not get inside and aggressive antiseptics do not touch the mucous membrane.
- Unsealing — The doctor removes the old filling material, posts, and core build-ups.
- Mechanical and medicinal treatment — The canals are widened and flushed with special solutions. Treatment with a microscope at this stage allows for finding and processing all canal branches (“deltas”).
- Temporary filling — Medicine is often placed inside for 1–2 weeks to completely destroy the infection in the bone (periodontitis).
- Final sealing — The canals are tightly sealed with heated gutta-percha under optical control.
Is it worth it?
Retreatment is a more expensive and complex procedure than primary care. However, preserving your own tooth is a higher priority than even the best implant. Your own root maintains the natural load on the bone and the biomechanics of the dental system.
If an old tooth has started to ache, reacts to biting, or a fistula has appeared on the gum — do not rush to extract it. Modern dental treatment under a microscope provides an opportunity to correct past mistakes and extend the life of a tooth for decades.
Remember: correct diagnosis and working with magnification are the keys to ensuring a third time won’t be necessary!
