When should root canal retreatment be considered?

Root canal retreatment should indeed be considered when the canal space is grossly contaminated. Contamination indicates that there is an infection or failure in the previous endodontic treatment, preventing healing and leading to persistent symptoms such as pain or swelling. This indicates the need to re-access the canal system to remove the infected tissue and thoroughly clean and disinfect the area before potentially sealing it again.

In situations involving other factors, such as the canal being filled with excessive sealer material, lack of root closure, or presence of a fracture in the tooth, these may contribute to the decision-making process, but they do not directly indicate contamination of the canal space. These conditions can sometimes be managed in alternative ways without necessarily leading to retreatment, as they may not inherently lead to continued infection. Ultimately, gross contamination necessitates immediate action to ensure the health of the surrounding tooth structure and overall oral health.