Overview

Technological advancements and improved clinical expertise have significantly enhanced the quality and predictability of endodontic treatment, making it a preferred alternative to tooth extraction. Increased public awareness, effective pain control, and improved long-term outcomes have contributed to the growing acceptance of root canal therapy. However, endodontic failure remains a clinical concern, most commonly due to persistent microbial infection, procedural errors, or complex root canal anatomy, with Enterococcus faecalis frequently implicated. Epidemiological studies continue to report notable failure rates, creating a ""good news-bad news"" paradox in modern endodontics. Nonsurgical endodontic retreatment remains the most conservative and preferred option for managing failed cases, aiming to eliminate infection and achieve optimal canal disinfection and obturation. While success rates vary, particularly in teeth with periapical lesions, advancements in instruments, materials, and techniques have improved outcomes. When conventional retreatment is unsuccessful, endodontic microsurgery offers a highly predictable alternative with superior success rates.

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