Cracked Root and a Re-treatment, but still Have Problems

I had a root canal treatment and dental crown placed on a molar. Years later it started hurting again. I went to another endodontist and he discovered another canal. He told me success was not a guarantee and gave me the odds of success. They weren’t great but weren’t horrible either. He also mentioned the possibility of a cracked root. He said they’re hard to detect and if I have one other problems will develop. I had a second root canal treatment and an apicoectomy. It was fine for a while, but now has started hurting again. Should I get a third re-treatment. Are cracked roots really hard to detect?

Ellie

Dear Ellie,

The reason your endodontist gave you odds is that a dentist can do everything right and a root canal treatment can still fail. They are definitely worth trying in order to save a tooth and most of them succeed. But, there can be hidden canals, especially in a molar. Plus, some of them will turn at a 90 degree angle, which makes it impossible for the dental tools to get everything.

Normally, I am all for saving tooth structure, and a second root canal re-treatment can do the trick, but a third re-treatment has little chance of success. In your case, I think your best option is to have the tooth extracted and get a dental implant. These are fantastic tooth replacements and have much higher odds than a third root canal.

As to whether or not a cracked root is hard to find, that is definitely the case. You can’t see cracks in a tooth root, even on an x-ray. 3D imaging, such as Cone Beam Computed Tomography, does a bit better.

This blog is brought to you by a San Antonio Endodontist Dr. Scott Janse.