, Volume 107, Issue 4, pp 536–545 | Cite as

Clinical outcomes of non-surgical multiple-visit root canal retreatment: a retrospective cohort study

  • Keziban OlcayEmail author
  • Tan Fırat Eyüboglu
  • Mutlu Özcan
Original Article


This study aimed to investigate the effects of several clinical factors on the success and survival rates of multiple-visit non-surgical root canal (NSRC) retreatment. Failed endodontically treated 236 teeth in 161 patients (18–72 years, 48% males; and 52% females) were retreated between March 2014 and December 2015 and were enrolled in this study. Two calibrated examiners evaluated the preoperative, intraoperative, and postoperative outcomes using the periapical index (PAI) scores. The teeth were classified as healed (healthy apical tissues, PAI ≤ 2, no signs or symptoms), healing (no signs and symptoms, PAI > 2 but reduced from the initial PAI score), and not-healed (presence of apical periodontitis, signs and/or symptoms, PAI > 2). The teeth scored as healed and healing was considered to be successful, while the not-healed ones were considered as failures. Of the 236 teeth, 135 (57.3%) in 103 patients (63.9%) were lost to follow-up, yielding to follow-up of 101 teeth (42.7%) in 58 patients (36%). Three teeth were extracted yielding to an overall success rate of 85.1%, at a mean observation time of 33.8 months. The teeth with periapical lesions < 5 mm had an 88.6% success rate, while those ≥ 5 mm had an 80% success rate (P > 0.05). While, age, gender, preoperative, intraoperative, and postoperative factors did not significantly affect the outcomes (P > 0.05), tooth type significantly affected the success rate (P < 0.05). The most frequently failed teeth were the mandibular first molars (P < 0.05). Based on these results, the multiple-visit NSRC retreatment exhibited a favorable success rate and could be offered for the endodontically failed teeth.


Multiple-visit endodontic treatment Non-surgical retreatment Root canal therapy Success rate Survival rate 



This study was not supported by any funding source.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study, formal consent is not required.

Informed consent

Informed consent was obtained from all participants included in the study.


  1. 1.
    Schilder H. Filling root canals in three dimensions. Dent Clin North Am. 1967;11:723–44.Google Scholar
  2. 2.
    Schilder H. Cleaning and shaping the root canal. Dent Clin North Am. 1974;18:269–96.Google Scholar
  3. 3.
    Dammaschke T, Steven D, Kaup M, et al. Long-term survival of root-canal-treated teeth: a retrospective study over 10 years. J Endod. 2003;29:638–43.CrossRefGoogle Scholar
  4. 4.
    Alley BS, Kitchens GG, Alley LW, et al. A comparison of survival of teeth following endodontic treatment performed by general dentists or by specialists. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2004;98:115–8.CrossRefGoogle Scholar
  5. 5.
    Salehrabi R, Rotstein I. Endodontic treatment outcomes in a large patient population in the USA: an epidemiological study. J Endod. 2004;30:846–50.CrossRefGoogle Scholar
  6. 6.
    Olcay K, Ataoglu H, Belli S. Evaluation of related factors in the failure of endodontically treated teeth: a cross-sectional study. J Endod. 2018;44:38–45.CrossRefGoogle Scholar
  7. 7.
    Ashraf H, Milani AS, Shakeri Asadi S. Evaluation of the success rate of nonsurgical single visit retreatment. Iran Endod. 2007;2:9–72.Google Scholar
  8. 8.
    Eyuboglu TF, Olcay K, Özcan M. A clinical study on single-visit root canal retreatments on consecutive 173 patients: frequency of periapical complications and clinical success rate. Clin Oral Investig. 2017;21:1761–8.CrossRefGoogle Scholar
  9. 9.
    Sjogren U, Hagglund B, Sundqvist G, et al. Factors affecting the long-term results of endodontic treatment. J Endod. 1990;16:498–504.CrossRefGoogle Scholar
  10. 10.
    Ng YL, Mann V, Gulabivala K. Outcome of secondary root canal treatment: a systematic review of the literature. Int Endod J. 2008;41:1026–46.CrossRefGoogle Scholar
  11. 11.
    He J, White RK, White CA, Schweitzer JL, Woodmansey KF. Clinical and patient-centered outcomes of nonsurgical root canal retreatment in first molars using contemporary techniques. J Endod. 2017;43:231–7.CrossRefGoogle Scholar
  12. 12.
    Torabinejad M, Corr R, Handysides R, et al. Outcomes of nonsurgical retreatment and endodontic surgery: a systematic review. J Endod. 2009;35:930–7.CrossRefGoogle Scholar
  13. 13.
    Salehrabi R, Rotstein I. Epidemiologic evaluation of the outcomes of orthograde endodontic retreatment. J Endod. 2010;36:790–2.CrossRefGoogle Scholar
  14. 14.
    Moazami F, Sahebi S, Sobhnamayan F, et al. Success rate of nonsurgical endodontic treatment of nonvital teeth with variable periradicular lesions. Iran Endod J. 2011;6:119–24.Google Scholar
  15. 15.
    Friedman S, Lost C, Zarrabian M, et al. Evaluation of success and failure after endodontic therapy using glass ionomer cement sealer. J Endod. 1995;21:384–90.CrossRefGoogle Scholar
  16. 16.
    Ricucci D, Russo J, Rutberg M, et al. A prospective cohort study of endodontic treatments of 1369 root canals: results after 5 years. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2011;112:825–42.CrossRefGoogle Scholar
  17. 17.
    Siqueira JF Jr, Rôças IN. Clinical implications and microbiology of bacterial persistence after treatment procedures. J Endod. 2008;34:1291–301.CrossRefGoogle Scholar
  18. 18.
    Ricucci D, Siqueira JF Jr. Fate of the tissue in lateral canals and apical ramifications in response to pathologic conditions and treatment procedures. J Endod. 2010;36:1–15.CrossRefGoogle Scholar
  19. 19.
    Sundqvist G, Figdor D, Persson S, et al. Microbiologic analysis of teeth with failed endodontic treatment and the outcome of conservative re-treatment. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1998;85:86–93.CrossRefGoogle Scholar
  20. 20.
    Siqueira JF Jr, Rôças IN. Exploiting molecular methods to explore endodontic infections: part 2-redefining the endodontic microbiota. J Endod. 2005;31:488–98.CrossRefGoogle Scholar
  21. 21.
    Siqueira JF Jr. Aetiology of root canal treatment failure: why well-treated teeth can fail. Int Endod J. 2001;34:1–10.CrossRefGoogle Scholar
  22. 22.
    Sjögren U, Figdor D, Spångberg L, et al. The antimicrobial effect of calcium hydroxide as a short-term intracanal dressing. Int Endod J. 1991;24:119–25.CrossRefGoogle Scholar
  23. 23.
    Paiva SS, Siqueira JF Jr, Rôças IN, et al. Clinical antimicrobial efficacy of NiTi rotary instrumentation with NaOCl irrigation, final rinse with chlorhexidine and interappointment medication: a molecular study. Int Endod J. 2013;46:225–33.CrossRefGoogle Scholar
  24. 24.
    Orstavik D, Kerekes K, Eriksen HM. The periapical index: a scoring system for radiographic assessment of apical periodontitis. Endod Dent Traumatol. 1986;2:20–34.CrossRefGoogle Scholar
  25. 25.
    Nesković J, Zivković S, Medojević M, et al. Outcome of orthograde endodontic retreatment—a two-year follow-up. Srp Arh Celok Lek. 2016;144:174–80.CrossRefGoogle Scholar
  26. 26.
    Allen RK, Newton CW, Brown C. A statistical analysis of surgical and nonsurgical endodontic retreatment cases. J Endod. 1989;15:261–6.CrossRefGoogle Scholar
  27. 27.
    Fristad I, Molven O, Halse A. Nonsurgically retreated root filled teeth—radiographic findings after 20–27 years. Int Endod J. 2004;37:12–8.CrossRefGoogle Scholar
  28. 28.
    Imura N, Pinheiro ET, Gomes BP, Zaia AA, Ferraz CC, Souza-Filho FJ. The outcome of endodontic treatment: a retrospective study of 2000 cases performed by a specialist. J Endod. 2007;33:1278–82.CrossRefGoogle Scholar
  29. 29.
    de Chevigny C, Dao TT, Basrani BR, Marquis V, Farzaneh M, Abitbol S, Friedman S. Treatment outcome in endodontics: the Toronto study—phases 3 and 4: orthograde retreatment. J Endod. 2008;34:131–7.CrossRefGoogle Scholar
  30. 30.
    Bergenholtz G, Lekholm U, Milthon R, Milthon R, Heden G, Odesjö B, Engström B. Retreatment of endodontic fillings. Scand J Dent Res. 1979;87:217–24.Google Scholar
  31. 31.
    Caliskan MK. Nonsurgical retreatment of teeth with periapical lesions previously managed by either endodontic or surgical intervention. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2005;100:242–8.CrossRefGoogle Scholar
  32. 32.
    Zadik Y, Sandler V, Bechor R, Salehrabi R. Analysis of factors related to extraction of endodontically treated teeth. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008;106:e31–5.CrossRefGoogle Scholar
  33. 33.
    Burry JC, Stover S, Eichmiller F, Bhagavatula P. Outcomes of primary endodontic therapy provided by endodontic specialists compared with other providers. J Endod. 2016;42:702–5.CrossRefGoogle Scholar
  34. 34.
    Aminoshariae A, Kulild J. Master apical file size—smaller or larger: a systematic review of microbial reduction. Int Endod J. 2015;48:1007–22.CrossRefGoogle Scholar
  35. 35.
    Kirkevang LL, Ørstavik D, Wenzel A, Vaeth M. Prognostic value of the full-scale Periapical Index. Int Endod J. 2015;48:1051–8.CrossRefGoogle Scholar
  36. 36.
    Kirkevang LL, Ørstavik D, Bahrami G, Wenzel A, Vaeth M. Prediction of periapical status and tooth extraction. Int Endod J. 2017;50:5–14.CrossRefGoogle Scholar
  37. 37.
    Pope O, Sathorn C, Parashos P. A comparative investigation of cone-beam computed tomography and periapical radiography in the diagnosis of a healthy periapex. J Endod. 2014;40:360–5.CrossRefGoogle Scholar

Copyright information

© The Society of The Nippon Dental University 2019

Authors and Affiliations

  1. 1.Department of Endodontics, Faculty of DentistryIstanbul Medipol UniversityIstanbulTurkey
  2. 2.Dental Materials Unit, Center for Dental and Oral Medicine Clinic for Fixed and Removable Prosthodontics and Dental Materials ScienceUniversity of ZürichZurichSwitzerland

Personalised recommendations