A dental X-ray is always taken before treatment to assess the anatomy and damage around the roots. Sometimes, a three-dimensional computed tomography scan is necessary when the anatomy is complex or locating the source of pain is challenging.

Local anesthesia is administered.

The tooth is isolated with a rubber dam system to protect the opened tooth from saliva contamination, as bacteria in saliva could be the cause of unresolved inflammation, requiring tooth re-treatment.

All previous fillings are removed, and it is checked under a microscope whether the tooth is cracked.

Using a microscope, small instruments clean all found tooth canals. The length of each canal is measured to ensure that cleaning instruments reach the very tips. Usually, they are very narrow, approximately the thickness of an eyelash, making the process slow and requiring meticulousness and patience.

Canal irrigation with disinfectant solutions is performed, and if necessary, temporary filling is placed until the next visit.

The root canals are filled with a special material and sealed tightly with a filling.

X-rays are repeated at various stages of treatment to evaluate the length of the root canals and the quality of their filling. 

Duration of Endodontic Treatment

Endodontic treatment usually requires multiple visits, and between appointments, patients may experience pain, occasionally accompanied by swelling. If the tooth is immediately restored with a tight filling after endodontic treatment, the prognosis is good, with success rates reaching about 95%. 

Endodontic Re-Treatment 

When is endodontic re-treatment necessary? 

Even if root canals were previously treated well, if decay occurs in the tooth, the filling falls out, or the tooth crown breaks, the root canal system loses its integrity, resulting in recurrent tooth infection, necessitating root canal re-treatment. 

Root canals also need to be re-treated if during the previous treatment:

1. Not all root canals were found.

2. Canals were not filled up to the root tips.

3. An instrument separated in the canal during treatment, leaving it uncleansed.

4. There are posts in the canals that need to be removed before prosthetic treatment.  

The procedures are complicated by the fact that to clean the canals, we must first remove all previous materials from them, and additionally, significantly more resistant microorganisms reside in previously treated and re-infected canals. Therefore, the success rate of re-treatment ranges from 60% to 90%, depending on the situation.