Persistent endodontic infection--re-treatment or surgery?

Area of Science:

• Endodontics
• Dental infections
• Periradicular disease management

Background:

• Persistent periradicular disease often stems from intraradicular infection.
• Conventional endodontic retreatment is the primary treatment approach.
• Endodontic surgery is a viable alternative for specific cases.

Purpose of the Study:

• To outline the management strategies for persistent periradicular disease.
• To compare the outcomes of endodontic retreatment and surgery with tooth loss rehabilitation.
• To emphasize case selection criteria for optimal treatment planning.

Main Methods:

• Review of management modalities for persistent periradicular disease.
• Evaluation of success and survival rates for endodontic retreatment and surgery.
• Comparison of outcomes between endodontic treatments and implant-supported crowns.

Main Results:

• Both conventional endodontic retreatment and endodontic surgery demonstrate high long-term success and survival rates.
• Endodontic management of persistent periradicular pathology offers outcomes comparable or superior to tooth loss and rehabilitation.
• Successful retreatment or surgery preserves the natural tooth with potentially better long-term benefits.

Conclusions:

• Endodontic retreatment should be the primary treatment of choice for persistent periradicular disease.
• Surgical endodontics is a valuable option when conventional retreatment is insufficient or contraindicated.
• Preserving the natural tooth through endodontic interventions is often more beneficial than extraction and prosthetic rehabilitation.