Endodontic Topics 2011, 18, 1–2
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Editorial
Post-treatment endodontic disease and re-treatment
PAUL DUMMER, GUEST EDITOR
This volume of Endodontic Topics and the next cover
the critically important subject of root canal re-
treatment using a conventional (non-surgical) ortho-
grade approach in order to cure what, to date, has been
termed post-treatment periradicular disease that per-
sists or emerges following primary root canal treat-
ment. The overall aim is to provide a critical review of
the essential components of this fascinating, compel-
ling, and complex field within Endodontology, and to
provide biological and clinical information across the
entire spectrum of the challenges that face dentists on a
day-to-day basis. These challenges include the very
important steps of diagnosis and management plan-
ning as well as the often technically demanding clinical
stages that are required to control canal infection,
prevent re-infection, and restore teeth that have already
been subjected to various forms of treatment (abuse!).
Thus, the volumes will appeal to those who wish to
learn more about the epidemiology of periradicular
disease following root canal treatment, those interested
in the etiology of the disease, as well as those clinicians
who need to understand what treatment is required
and how to provide it. The first volume focuses on the
biological sciences that underpin the clinical sciences
which are covered in the second volume.
The first paper by Ng & Gulabivala sets out the
extent of the challenge by critically analyzing the
biological outcomes of root canal treatments and re-
treatments as reported in the literature. In doing so,
the paper clearly defines the prevalence of apical
pathosis associated with root-filled teeth and starkly
identifies the magnitude of the challenge facing the
profession. On a related topic, the second paper by
Haapasalo, Shen & Ricucci sets out to explain why
root-filled teeth are often associated with periradicular
2011 r John Wiley & Sons A/S
ENDODONTIC TOPICS 2011
1601-1538
disease and goes on to critically review the possible
contributing factors and local consequences that may
result from disease which is left untreated.
The third paper by Kirkevang reviews previously
conducted observational studies on root canal treat-
ment and apical periodontitis (AP). Figdor & Gulabi-
vala then describe in detail the microbiota of canals in
root-filled teeth associated with periradicular disease.
In the second volume, the close link between
etiology of disease and treatment is then pursued in
the fifth paper by Abbott, who provides a comprehen-
sive review of diagnostic strategies and management
options, including the re-treatment/implant decision-
making process.
Papers 6 through 10 review and describe contem-
porary clinical techniques necessary to control infec-
tion and prevent re-infection. These papers are not only
based on critical reviews of the literature but also call
upon the extensive clinical experience of the authors to
provide a state-of-the-art overview of what treatment is
required and how it should be provided. The sixth
paper by Rhodes deals with access to pulp chambers
and root canals where previous intra-coronal restora-
tions, crowns, bridges, and posts must be disas-
sembled. The seventh paper by Duncan & Chong
provides an overview of the clinical procedures
necessary to remove root filling materials, their
success/failure rates as well as the risks associated with
them.
Disinfection of the re-accessed root canal system is
covered by Zehnder & Paqué in the eighth paper. They
provide a critical review of the literature on disinfection
protocols with an emphasis on current knowledge and
future trends in infection control within re-treated
teeth, including the use of ultrasound. The ninth paper
1
Dummer
by Hülsmann, Drebenstedt & Holscher concentrates
on shaping and filling canals during re-treatment
procedures and attempts to link clinical techniques to
outcomes. The tenth paper by Mannocci, Bhuva &
Stern focuses on restoring what are often severely
compromised teeth following root canal re-treatment.
Finally, Sathorn & Parashos provide a review of clinical
protocols for the follow-up and review of re-treated teeth
to emphasize the importance of ongoing monitoring
and to provide a useful methodology to follow.
I am extremely grateful to the authors for their
contributions to these two volumes of Endodontic
Topics. I am convinced their expertise and endeavors on
the subject of root canal re-treatment provide an up-to-
date and comprehensive review of the challenges facing
the profession when dealing with periradicular disease
associated with root-filled teeth. I have no doubt this
volume will become a most valuable resource for
clinical scientists and practising dentists with an interest
in Endodontology.