Abstract:

Periradicular surgery is a surgical procedure which is used in cases of failed endodontic treatments of a tooth with a persistent periapical lesion, which cannot be managed with endodontic retreatment. Various techniques and strategies have been trailed and applied to achieve with most minimally invasive procedures the cure of this pathology. Success in this procedure is predicated on many factors by preventing bacterial leakage from the root-canal system into the periradicular tissues. The precise placement of the root-end filling material following root-end resection could be critical for the treatment outcome. The presence of bacteria in the root canals is a prerequisite for the development of periapical lesions. With modern approaches the rate of successful combined endodontic and surgical approach has drastically increased, this is due to the wide ranges of endo systems, microscopes, ultrasonics and compatible root and root-end filling materials which will result in less trauma to the patient and quicker post endo and post-surgical healing. With the uses of such instruments and materials, advantage can be taken in the treatment process including easier identification of root apices, root filling, microsurgical approach as smaller osteotomies, shallower resection angles of root, and hermetic sealing within the prepared root-end cavity. With this review we aim to describe the current successful strategies for periradicular surgery.

Keywords: apical surgery, endodontic surgery, periradicular surgery, root-end filling, root-end resection, retrograde filling