Persistent symptoms
A feeling of pressure, tenderness when biting or a dull ache in a tooth that has already had root canal treatment — even years afterwards.
02 — Endodontic retreatment
Root canal
retreatment in Kiel.
A second chance for your tooth — even when others are already recommending extraction. With a dental operating microscope, CBCT and a bioceramic root filling we achieve success rates of over 85% in root canal retreatment.
What is it?
Retreatment
instead of extraction.
Endodontic retreatment is a repeat root canal treatment on a tooth that has already been treated. It is the first choice when an existing root filling is not sufficient — before extraction and an implant are even considered.
Studies show: 30–40% of all root-treated teeth develop problems in the long term — often because canals were missed during the first treatment, the irrigation protocols were not adequate or the restoration leaked. With modern microscopic techniques most of these problems can be corrected today.
We take the time for an honest assessment: can your tooth be saved? In more than 80% of the cases we see the answer is: yes.
When is it needed?
Signs
you may need retreatment.
Retreatment becomes necessary when symptoms persist or reappear after a root canal treatment — or when the radiograph shows inflammation that has not healed.
Sinus tract on the gum
A recurring ‘spot’ on the gum above the treated tooth — a sign of chronic inflammation at the root apex.
Apical radiolucency on the radiograph
A dark zone at the root end — a sign of chronic bone inflammation, often symptom-free for years.
Incomplete root filling
The root filling does not reach the root apex, has gaps or shows leaking areas — visible on the radiograph.
New restoration planned
Before an expensive crown or bridge is placed on a root-treated tooth — making sure the root filling is sealed.
Leaking restoration
When the crown or filling above the root filling has started to leak and bacteria can reach the canal system again.
Our approach
Why retreatment
works.
Retreatment is more demanding than the first treatment. It calls for different instruments, more experience — and above all a microscope, without which many findings stay invisible.
Finding missed canals
The most common reason for failure: a canal that was never found. The second mesiobuccal canal (MB2) in upper molars in particular is missed in up to 40% of cases. With a microscope and CBCT we find it.
Removing the old filling gently
Gutta-percha, posts, separated instruments — we remove old materials precisely under the microscope, without losing healthy tooth structure unnecessarily.
Breaking down bacterial biofilm
Chronic infections live in biofilms — resistant to simple irrigation. We activate the irrigating solutions with ultrasonic and sonic systems in order to remove even stubborn biofilms.
3D diagnostics with CBCT
Almost always indicated in retreatment. The CBCT shows hidden canals, root fractures, the extent of apical lesions and the true root anatomy. More on CBCT diagnostics
How it works in practice
Retreatment
step by step.
01
3D diagnostics (CBCT)
Before every retreatment: three-dimensional imaging. Hidden canals, root fractures, the true extent of the inflammation — visible before we treat.
02
Information & plan
We go through the findings, the prospects of success and the possible alternatives — openly and honestly. Only then do we begin.
03
Access & disassembly
Under the microscope we remove the old restoration — crown, core build-up and, where present, root posts. Gently, with minimal loss of tooth structure.
04
Removing the old root filling
Gutta-percha and sealer are removed from every canal under the microscope and with special solvents. Hidden canals are located.
05
Activated irrigation
Ultrasonically activated disinfecting solutions also reach the areas that cannot be reached mechanically — isthmuses, lateral canals, apical deltas.
06
Medicated dressing
For severely inflamed teeth: a calcium hydroxide dressing for 1–4 weeks to eliminate remaining bacteria. In straightforward cases this step is not needed.
07
Bioceramic root filling
A dense three-dimensional filling with gutta-percha and a bioceramic sealer — modern materials that bond with the root instead of merely sealing it.
08
Final restoration & follow-up
The tooth is built up stably, and your own dentist places the final crown. After 6 and 12 months we check the result radiographically.
85%+
Success rate
Retreatment carried out under the microscope achieves success rates of 80–90%.
~40%
missed MB2
Up to 40% of second mesiobuccal canals are missed without a microscope — we find them.
2–3
visits
Retreatment is more complex than a first treatment — typically 2–3 visits.
Costs
What does
retreatment cost?
Retreatment is more involved than a first treatment: more visits, more demanding diagnostics, often a CBCT, longer work under the microscope. The fees reflect this effort.
The statutory health insurance does not routinely cover retreatment — it is a private service. Patients with private health insurance are as a rule fully reimbursed under the GOZ (German scale of dental fees).
Guide prices
- Anterior tooth retreatment: approx. €600–900
- Premolar retreatment: approx. €800–1,200
- Molar retreatment: approx. €1,000–1,500
- Complex retreatment with post removal: approx. €1,200–1,800
- CBCT (if required): approx. €100–250
Before every treatment we draw up a written treatment and cost plan. You know exactly what to expect — no surprises.
Common questions
Answers
before retreatment.
What patients ask most often — before they decide on retreatment.
Why does a root canal treatment sometimes fail?
The most common reasons: missed canals (e.g. the second mesiobuccal canal MB2 in an upper molar — up to 40% are missed without a microscope), incomplete cleaning owing to complex anatomy, a leaking root filling or a leaking crown above the root filling, through which bacteria enter again.
With a microscope and CBCT diagnostics we identify most of these causes — and can usually put them right.
What is the success rate of root canal retreatment?
Retreatment carried out under the microscope achieves success rates of 80–90%. This requires careful diagnostics (usually with CBCT), a microscope, an experienced practitioner and modern irrigation protocols.
For teeth without these conditions the success rate of retreatment is often only around 50%.
My dentist says the tooth cannot be saved — is that true?
For many teeth judged not worth keeping, retreatment is still possible. Only after microscopic diagnostics with CBCT can it be assessed reliably whether keeping the tooth makes sense.
A second opinion is almost always worth it. Our principle: if we cannot save the tooth, we tell you honestly and go through the alternatives with you.
What does a root canal retreatment cost?
Costs are usually between 800 and 1,500 euros, depending on the tooth, the number of canals and the level of difficulty. Complex retreatment with post removal can cost more.
Patients with private health insurance are as a rule fully reimbursed under the GOZ. The statutory health insurance does not routinely cover retreatment.
Retreatment or an implant — which makes more sense?
Studies show comparable success rates for retreatment (~85%) and implants (~95%). But: your own tooth has advantagesthat no implant can replace — its own proprioception, natural aesthetics, no foreign body in the bone.
Retreatment is often less expensive and less invasive. Our advice: look at every option for keeping the tooth first — an implant is still possible afterwards.
What if there is a post in the tooth?
Post removal is demanding, but with a microscope and ultrasonics it is possible today in the vast majority of cases — including fibreglass, titanium and cast posts. More on this: Separated instrument & post removal
Do I need a referral?
No. You can book an appointment with us directly — even without a referral from your own dentist. If possible, please bring recent radiographs with you; it speeds up the diagnosis.
When is an apicoectomy more appropriate than retreatment?
If orthograde retreatment is technically not possible — for example with posts that cannot be removed, firmly lodged separated instruments or certain anatomical situations — an apicoectomy may be the right choice.
In most cases retreatment is the first step — and only if it does not succeed does the surgical procedure come into play.
More treatments
When retreatment
is not enough.
Sometimes a tooth needs more than retreatment — we have the specialised procedures required.
Surgery
apicoectomy
Microsurgical procedure when orthograde treatment reaches its limits.
Find out more AdvancedSeparated instrument & post removal
Removing separated instruments or root posts under the microscope.
Find out more DiagnosticsCBCT — 3D imaging
Three-dimensional imaging for predictable results.
Find out more RepairPerforation repair
Sealing iatrogenic defects in the root wall with MTA/bioceramics.
Find out moreBook
Tooth already treated?
We can help.
Second opinion & diagnostics can be booked directly. Please bring your recent radiographs with you.