Evaluation and clinical management of previous endodontic therapy

Endodontic recall studies and clinical experience have resulted in more universal criteria for acceptable and unacceptable endodontic treatment. Before the initiation of restorative treatment on teeth previously treated endodontically, the prosthodontist should evaluate the quality of endodontic treatment to assure that it will provide a risk-free, permanent, solid foundation for the future restorative work. Lack of symptoms alone does not indicate success of endodontic treatment. Radiographic evaluation is also not sufficient. The prosthodontist should use a thorough and combined evaluation of the endodontic history, radiographic evaluation, and tooth and tissue examination, as well as physically assess the treatment of all canals and their seals. As a rule, endodontics of questionable quality should be retreated by way of the canal. The removal of defective restorations is done to facilitate the retreatment effort and assure the soundness of tooth structure. Following retreatment, the tooth is restored and healing of the patient is followed up. Surgical endodontics is avoided unless retreatment is first attempted or the quality of previous root canal therapy is acceptable or the canal obstructed.