Should you be re-treating that root canal—or referring it out?

What are the red flags that scream “specialist only”?

How do you confidently remove GP without compromising disinfection?

Dr. Ayman Al-Sibassi joins Jaz in this endo-packed episode to help you navigate the tricky world of root canal re-treatments. From solvent selection and GP removal techniques to assessing case difficulty, they break down everything a GDP needs to know to make smart, confident decisions.

You’ll learn how to spot the cases you should be tackling, which ones to send to your endodontist, and what tools and techniques will make the re-treatment process smoother and safer. Because not all re-treatments are created equal—and some are surprisingly simple once you know what to look for.

https://www.youtube.com/watch?v=apMtcuNTLqI Watch PDP233 on YouTube

Protrusive Dental Pearl: A crack in a bonded ceramic restoration isn’t necessarily a failure!

Just like we accept cracks in natural enamel, we can also accept cracks in ceramics—as long as it’s been properly bonded.

Shoutout to Dr. Pascal Magne for this powerful mindset shift!

Key Takeaways

• Specialist training in endodontics includes a variety of surgical skills.
• The complexity of root canal retreatments varies significantly.
• General dentists can perform some retreatments, but should assess complexity carefully.
• Patient consent is essential, especially regarding potential unrestorability.
• Communication about fees should be clear and upfront with patients.
• Red flags for retreatment include poor coronal seal and previous treatment quality.
• CBCT imaging is becoming increasingly important in endodontic practice.
• Collaboration between general dentists and specialists enhances patient outcomes. Many referrals stem from straightforward cases that are poorly managed.
• Using solvents can aid in GP removal but should be approached cautiously.
• Single visit treatments are often preferred for patient convenience.
• Adequate disinfection is crucial, sometimes necessitating a second visit.
• The survival rate of root canal-treated teeth is comparable to implants.
• Patient age and overall health should guide treatment decisions.
• Understanding the difference between success and survival in endodontics is essential.

Highlights of this episode:

• 00:00 Introduction
• 05:02 — Protrusive Dental Pearl: Cracks in enamel vs. dentine 
• 06:34 — Guest Introduction: Dr. Ayman Al-Sibassi and his journey into Endo 
• 11:03 Assessing the complexity of re-treatments and when to refer
• 15:21 The role of CBCT in diagnosis and treatment planning
• 17:47 Ethical and financial dilemmas: charging for unrestorable teeth
• 22:05 Red flags in root canal re-treatments
• 34:55 Techniques for GP removal and file selection
• 47:07 Cost vs. predictability: re-treatment vs. implants and long-term outcomes

Take a look at this Endodontic Complexity Assessment Tool to help you evaluate how challenging a root canal case really is.

If you enjoyed this episode, you’ll definitely want to check out: Stop Being Slow at Root Canals! Efficient RCTs with Dr. Omar Ikram – PDP163

This episode is eligible for 1 CE credit via the quiz on Protrusive Guidance. 

This episode meets GDC Outcomes B and C.

AGD Subject Code: 070 ENDODONTICS (Non-surgical treatment)

 #PDPMainEpisodes #EndoRestorative

Aim:

To provide clinicians with a structured approach to diagnosing, planning, and executing simple Re-Root Canal Treatments (Re-RCTs), while recognizing case limitations and improving treatment outcomes.

Dentists will be able to:

Identify clinical situations where Re-RCT is appropriate and distinguish them from cases requiring referral or alternative treatment. Describe the potential challenges such as canal blockages, separated instruments, or apical complications, and know when to refer. Communicate effectively with patients regarding prognosis, risks, and treatment expectations, including the need for possible referral.