Nonsurgical Retreatment of Endodontically Treated Teeth: A Prospective Cohort Study on Success Rates and Quality of...

The present study evaluated the clinical and patient-centered outcomes of nonsurgical retreatment of endodontically treated teeth. The primary goal was to assess the success rate, defined by clinical and radiographic criteria, while the secondary objectives focused on patient-reported quality-of-life outcomes using a validated oral health-related quality-of-life (OHRQoL) questionnaire.

This prospective cohort study was conducted from January 2024 to April 2025 at the Department of Conservative Dentistry and Endodontics and included 100 systemically healthy adults (aged 18-60 years) requiring retreatment of endodontically treated teeth. Patients with vertical root fractures, advanced periodontal disease, or non-restorable teeth were excluded. The procedure was performed using current/contemporary endodontic technologies such as rotary files, ultrasonic irrigation, and warm vertical compaction with gutta-percha and root canal sealer. Calcium hydroxide was used as an intracanal medication between visits. Outcomes were assessed six months after permanent restoration via clinical examinations and digital periapical radiographs, categorizing cases as healed, healing, or non-healing. OHRQoL scores were collected preoperatively and one- and six-months post-treatment using a modified questionnaire with a 1-5 Likert scale. Statistical analyses included Friedman's test for OHRQoL scores and Fisher's exact test for success rates with a significance level of p < 0.05.

Of 100 patients, 88 (88%) patients achieved successful outcomes (healed, healing, or non-healing). Maxillary jaw retreatments outperformed mandibular jaw retreatments, and cases with periapical lesions had higher success rates than those without periapical lesions. No demographic or clinical factor significantly influenced the success rate (p > 0.05). Successful cases showed significant OHRQoL improvement (p = 0.001) from baseline (32.13 ± 12.07) to six months (19.40 ± 12.07), while failed cases showed no significant change (p = 0.425).

Nonsurgical root canal retreatment in endodontically treated teeth achieved a high success rate with significant quality-of-life improvements in successful cases, underscoring the efficacy of standardized protocols and advanced technologies.