Root canal re-treatment with gutta percha - which techniques influence success?

Area of Science:

• Endodontics
• Dental Surgery
• Regenerative Medicine

Background:

• Root canal retreatment is a common procedure to save teeth with persistent or new infections.
• Gutta percha remains a widely used material for root canal obturation, necessitating an understanding of retreatment success rates.
• Assessing the efficacy of gutta percha root canal retreatment is crucial for improving patient outcomes and guiding clinical practice.

Purpose of the Study:

• To systematically review and meta-analyze the existing literature on the success rates of non-surgical root canal retreatment using gutta percha.
• To identify factors influencing the success or failure of root canal retreatment procedures.
• To provide evidence-based insights into the outcomes of gutta percha root canal retreatment.

Main Methods:

• A comprehensive literature search was conducted across major databases (PubMed, Cochrane, ScienceDirect, Scopus) and grey literature.
• Two endodontic specialists screened studies based on predefined inclusion/exclusion criteria, with a third investigator consulted if needed.
• Ten studies (2 RCTs, 7 prospective, 1 ambispective) with at least a 1-year follow-up evaluating gutta percha root canal retreatment were included.

Main Results:

• Under strict criteria, success rates were 71% (1-3 years) and 77% (4-5 years).
• Under loose criteria, the success rate was 87% (1-3 years).
• Factors negatively impacting success included older patients, mandibular/molar teeth, periapical radiolucency presence/size, higher initial periapical index scores, and multiple-visit retreatments.

Conclusions:

• Non-surgical root canal retreatment with gutta percha generally yields favorable outcomes.
• The presence and size of periapical radiolucency, initial periapical index scores, multiple-visit retreatments, and tooth characteristics significantly influence success rates.
• Careful consideration of these factors is essential for optimizing treatment planning and improving the prognosis of root canal retreatments.