Can a root filling be removed again?
A root filling can be removed from the tooth again. This is common when a root filling is too short or too long and does not fit optimally with the tip of the root. Furthermore, a tooth that causes persistent symptoms after a completed root filling also offers an indication to remove the root filling and insert a new one.
This procedure is called revision by the specialist. During the revision, special hand or machine files are used to remove the root filling from the canal and free it from all remnants. It is easier to remove freshly placed root fillings than to remove root fillings that have been in a canal for years.These are hardened by the sealer and are very hard, which makes a revision usually only possible in several application dates.
A calcinase is used as a rinse to loosen the old root filling. It is important to remove the tooth completely from all remains and to disinfect the canal system completely. Only after this step can another attempt be made to insert a root canal filling.
As a rule, we try to prepare the canals further than in the first attempt of the root filling. If the root canal filling is optimally placed, it is quite possible that a tooth will become asymptomatic. In case of further complaints, a root tip resection should be considered.
What happens if the root filling is too long?
A root filling that is too long and extends beyond the root tip of the affected tooth can cause discomfort, but can also remain without symptoms. If only the gutta-percha pin is a little too long, the tooth can still be calmed down, because the biocompatibility of the filling materials means that there is hardly any discomfort. Another possibility is that the sealer, which closes the gap between guttapercha and the root canal wall, is over-pressed during the insertion process.
This can push the sealer beyond the root tip and cause discomfort. In case of complaints of a too long root filling or overpressed material, the therapy is usually not the revision in which the root filling is removed from the canal. In most cases, apicoectomy is preferred, as it is possible to remove excess root filling material or overpressed sealers below the root tip.
A retrograde root canal filling is often performed in addition, in order to tightly seal the cut-off root tip. The cut end of the root is sealed tightly with cement or similar materials, a kind of root filling from below. In the case of teeth without symptoms, the dentist can also decide individually not to do anything at all, which is often the case if the root filling has already existed for a long time. In this situation it can also be decided to crown a tooth with a root filling that is too long. This depends on the initial situation and the patient’s history.
