Surgical Versus Non-Surgical Retreatment Outcomes in Failed Root Canal Case

Abstract

Background: Failure of root canal treatment is a common clinical challenge in endodontic practice and may result from persistent intraradicular infection, inadequate canal debridement, missed canals, or coronal leakage. Management of failed endodontic cases generally involves either non-surgical retreatment or surgical endodontic procedures such as apicoectomy. Determining the most effective treatment approach remains an important clinical decision in endodontic (Torabinejad et al., 2009; Ng et al., 2011).

Objective: To compare the clinical and radiographic outcomes of surgical versus non-surgical retreatment in failed root canal cases.

Methods: This prospective comparative clinical study was conducted at the Department of Dentistry, Sandman Provincial Hospital and SPH Quetta, Pakistan. A total of 100 patients presenting with failed root canal treatment were enrolled and allocated into two groups: Group A underwent non-surgical retreatment, while Group B received surgical endodontic retreatment (apicoectomy with retrograde filling). Patients were followed for 12 months. Treatment success was assessed based on clinical symptoms, radiographic healing, and absence of periapical pathology. Statistical analysis was performed using chi-square and independent t-tests with significance set at p < 0.05.

Results: Non-surgical retreatment demonstrated a high success rate in cases where the cause of failure was related to inadequate previous root canal therapy. Surgical retreatment showed favorable outcomes in cases with persistent periapical lesions or anatomical complexities. Overall success rates were slightly higher in the non-surgical retreatment group; however, surgical retreatment remained an effective alternative when conventional retreatment was not feasible.

Conclusion: Both surgical and non-surgical retreatment methods are effective for managing failed root canal cases. Non-surgical retreatment should be considered as the first line of treatment whenever feasible, while surgical intervention remains a reliable option for cases where conventional retreatment is not possible or has failed.