Robert Corr


Primary root canal therapy has been shown to be a predictable procedure with a high degree of success 1-4, however failures can occur after treatment. Treatment options for the preservation of teeth that have had previous endodontic treatment but demonstrate persistent disease include non-surgical (orthograde) or surgical (retrograde) endodontic retreatment, assuming the tooth is restorable, periodontally sound, and the patient desires to retain the tooth. The purpose of this study was to conduct a systematic review of the current available evidence to compare the clinical and radiographic outcomes of nonsurgical with those of surgical endodontic retreatment. Methodology began with targeted electronic searches of MEDLINE, PubMed, and Cochrane databases, which was followed with exhaustive hand searching and citation mining for all articles reporting clinical and/or radiographic outcomes of at least a mean 2 years recall for surgical and nonsurgical retreatment. Pooled and weighted success rates were determined from a meta-analysis of the data abstracted from the articles. RESULTS: When the unit of measure was roots, the data showed higher weighted success rates for non-surgical retreatment (86.7%) compared to surgical retreatment (81.1%) (p < 0.05). When the unit of measure was teeth, non-surgical retreatment showed higher weighted success rates (78.0) compared to surgical retreatment (75.0), although this failed to reach statistical significance (p > 0.05). Success for surgical retreatment declined with increasing recall intervals. Conversely, non-surgical retreatment showed a trend for increasing success with increasing time intervals. Non-surgical retreatment offers more favorable long-term healing compared to surgical retreatment.


Graduate Studies

First Advisor

Mahmoud Torabinejad

Second Advisor

Robert Handysides

Third Advisor

Shahrokh Shabahang

Degree Name

Master of Science (MS)

Degree Level


Year Degree Awarded


Date (Title Page)




Library of Congress/MESH Subject Headings

Root Canal Therapy -- methods; Dental Pulp Diseases -- surgery; Periapical Diseases -- pathology; Surgical Procedures, Operative; Treatment Failure; Comparative Study



Page Count

x; 69

Digital Format


Digital Publisher

Loma Linda University Libraries

Usage Rights

This title appears here courtesy of the author, who has granted Loma Linda University a limited, non-exclusive right to make this publication available to the public. The author retains all other copyrights.


Loma Linda University Electronic Theses and Dissertations

Collection Website


Loma Linda University. Del E. Webb Memorial Library. University Archives