Endodontic Microsurgery

Endodontic microsurgeries are of 2 types
Apical surgery involves apicoectomy and retrograde filling of the root canal.
Periradicular surgery involves treatment of root fractures, hemi-section of the tooth etc.

Apicectomy is an endodontic apical microsurgery that is performed under the microscope when infection persists around the apex of the tooth even after successful root canal treatment. The infected part of the apex of the root is surgically removed and the retrograde filling is done with a biocompatible material. Over a period of a few months, the apical area of the tooth heals and tooth is saved.

CASE 1

1. Before treatment - persistent periapical lesion

2. After removal of apical part, MTA placed

3. Follow up after 20 months- tooth asymptomatic

Root resection A tooth can have many roots. In case of a stubborn infection or cystic lesion around the apex of the root and also in case of a root fracture, one option would be the extraction of the tooth. The other option is to do a hemi-section or root resection (periradicular endodontic microsurgery) of the concerned tooth.

In a vertical fracture, half of the multi-rooted tooth, containing the fractured root is removed and the remaining half of the tooth, is root canal treated under the microscope, strengthened with a screw post and finally, restored with a full crown. Performing such a tough task is made less difficult with the use of a microscope
Advantages of root resection:
-Preservation of tooth
-Restoration of function

Endodontic Microsurgery

CASE 1

1. Before treatment - persistent periapical lesion

2. After removal of apical part, MTA placed

3. Follow up after 20 months- tooth asymptomatic

Case of Root Resection

Endodontic machine