Endodontics

Your last root canal failed. The tooth can usually still be saved.

Most re-treatments are finished over two visits, and 85 to 90% of them work.

Opened up

Failed root canal re-treatment

PKR 55,000

Consultation and X-ray is PKR 3,500 before it. Bring whatever films you were given last time; an older film beside a new one is worth having in the room.

WhatsApp the clinic Call +92 21 37443027

How you know

Four signs that the last one failed.

01
Pain on biting
The tooth hurts when you put load on it.
02
Swelling
Around the tooth or in the face beside it.
03
Pus discharge
From the gum beside the treated tooth.
04
Sudden severe pain
Out of nothing, often at night.

Any one of these is a reason to have the tooth looked at. Not all of them appear, and they do not always appear together.

What none of them tells you

Whether it can be saved

A symptom tells you that something is wrong. It does not tell you what, or whether the tooth can still be saved. That is decided at the examination, from the film and under magnification.

Ask about your tooth

Monday-Thursday & Saturday · 4:00-8:00 PM

Whether yours can be

It can be saved if two things are true.

Both have to hold. The second one is the one that usually decides it.

Condition one

There is enough tooth structure left.

Something has to be left to rebuild on once the old filling and the decay are out.

Condition two

The full length of every canal can be reached.

The main cause of failure is the first dentist not filling the canal to its full length, and they may have blocked it in a way that means it cannot be reopened all the way. This one matters most.

One case, treated 2016

A lower right first molar, with a separated file in it.

Treated in 2016 to the same protocols used today. It presented with pain, swelling and infection from a failed root canal, and a separated file in the canal, which was bypassed. The tooth was treated over multiple visits.

Before: radiograph of a lower right first molar — The failed root canal, with the separated file in place.

After: radiograph of a lower right first molar — Re-treated, with every canal filled to its full length.

Follow-up: radiograph of a lower right first molar — The follow-up film shows complete healing of the infection.

How long it takes

Two visits, fourteen days apart.

The gap is not scheduling. It is an antibiotic dressing left in the canals to kill what is left, and it is the reason a re-treatment is not a single visit.

Visit one

01
History, examination of the mouth, and the investigations the case calls for.
02
A diagnosis is established, and the plan is presented to you before treatment starts.
03
Under high magnification, all decay and the previous restorations are removed carefully.
04
The old root filling is removed and the correct working length of every canal is reached.
05
The canals are cleaned and disinfected, and an antibiotic dressing is placed.

Visit two

06
At the next visit the canals are filled to a 3D seal and a permanent filling is placed.

We keep treating the case until the tooth becomes completely symptomless. Some cases need another visit, and that is said before anything starts rather than after.

Ask about your caseMonday-Thursday & Saturday · 4:00-8:00 PM

Both options, with their real numbers

Re-treat it, or replace it.

You have usually been told the tooth is finished. It usually is not, but where it genuinely is, the alternative is named here with what it actually costs rather than left for you to find out later.

Re-treatmentExtraction and an implant

What it costsPKR 55,000, without a crownfrom PKR 170,000

How often it works85-90% of casesOver 1,000 placed here in 20 years

How long it takesUsually two visits, fourteen days apartAt least three months for the bone to integrate

What else it needsNothing beyond the tooth you already haveOften a bone graft as well, at PKR 70,000

Cone Beam CT, where it is needed

An advanced technique and an essential aid in diagnosis. Like a mini CT scan of the mouth, it shows what small films cannot.

The microscope, not a loupe

Magnification can be changed, and the maximum of 22-24× is far above what a loupe can reach. It also gives depth perception for accurate placement, and a lighting system bright enough to light up the dark areas inside a tooth.

85-90% success

Most cases arrive with infection already present, which is why they usually take more than one visit.

Nine questions, in two halves.

Split by what you are deciding: whether the tooth can be saved at all, and then what it costs and how it compares to pulling it.

Whether it can be saved

5 questions

01What does a failed root canal mean?

It means a tooth that has already had a root canal has developed infection and is now hurting.

02What are the signs of a failed root canal?

Four things patients notice: pain on biting, swelling, pus discharge, and sudden severe pain.

03How is a failed root canal diagnosed?

By understanding what went wrong first. That means a full history, an examination of the mouth, and investigations, small X-rays, and where the case needs it a CBCT scan, which is like a mini CT scan of the mouth. Only once all of that is in front of us is a plan made and put to the patient.

04Can the tooth be saved?

The tooth can be saved as long as there is enough tooth structure, and I can reach the full length of all the root canals. The second point is especially important.

05Can a failed root canal be saved?

Usually, yes, on two conditions. There has to be enough tooth structure left, and the full length of every root canal has to be reachable. The second matters most. The main cause of a failed root canal is the first dentist not filling the canal to its full length, and they may have blocked it in a way that means it cannot be reopened all the way.

Cost, visits and the alternative

4 questions

01How many visits will it take?

Usually two or more. We keep treating the case until the tooth becomes completely symptomless.

02Why is it more expensive to re-treat a failed root canal?

Because it takes more visits to complete, more specialised equipment is needed, and more materials are used than in a conventional root canal.

03Is re-treatment better than pulling the tooth and having an implant?

Re-treatment succeeds in 85 to 90% of cases and costs PKR 55,000. An implant with a crown starts at PKR 170,000, needs at least three months for the bone to integrate, and often a bone graft as well. Keeping your own tooth is usually both the cheaper and the quicker answer where it is possible.

04How successful is root canal re-treatment?

85 to 90%.

Published work