Selective Root Retreatment: A Randomized Clinical Trial

AbstractObjectives: Post-treatment apical periodontitis is an inflammatory disorder of peri-radicular tissues caused by either persistent or secondary intra-radicular infection . The present study compared the prognosis of cases treated with the “selective root retreatment”  concept to the traditional retreatment approach. Material and Methods: Forty patients complaining of failed root canal treatment having  a periapical lesion in one root were selected. The cases were randomly divided into two groups; group (S): selective root canal retreatment in which only the affected root was retreated and group (T): traditional root canal retreatment in which all canals were retreated. The peri-radicular condition was evaluated radiographically using the Periapical Index (PAI) for one year. The chi-square test statistical tests analyzed the outcome data. Results: At the baseline examination, There was no significant difference between the two groups regarding the patients’ baseline mean periapical indices . After one year, we found that the mean periapical index declined without a significant difference between the two groups. Conclusions: The present study points to selective root retreatment as a successful “minimally invasive alternative” in cases of an independently diseased root. The remaining treated roots can be retained without intervention provided that they are confirmed: “healthy”. Clinical Relevance: Selective root retreatment is a promising conservative option in the treatment of failed endodontic cases with periapical pathosis related to an individual root.