Selective Root Canal Retreatment: A Scoping Review and Metasynthesis by Thematic Analysis.

Abstract

Selective root canal retreatment preserves well-filled canals by treating only roots showing clinical or imaging evidence of failure, providing a minimally invasive alternative to conventional full retreatment. This scoping review, supported by metasynthesis through thematic analysis, synthesised clinical and imaging evidence in multirooted teeth. Five studies, including experimental research and case reports, were analysed. Thematic analysis revealed four core themes: clinical outcomes, imaging assessment, procedural features, and methodological limitations. Short-term outcomes of selective retreatment were comparable to full retreatment, with high tooth survival and low incidence of new lesions. Three-dimensional imaging played a pivotal role in detecting root-confined pathology, planning selective access, and supporting structural preservation. Evidence remains limited by small sample sizes, retrospective designs, and heterogeneity in study protocols. This review offers a structured synthesis of selective retreatment, integrating clinical and imaging insights to inform minimally invasive endodontic practice in a research and clinical context.