Endodontic Microsurgery

Traditional endodontic surgery involves the surgical management of a tooth with a periapical lesion that cannot be resolved by conventional non-surgical endodontic treatment/retreatment. The main objective of peri-radicular surgery is to promote tissue regeneration. Indications for surgery include complex root canal anatomy, irretrievable materials in the root canal, procedural accidents requiring surgery, persistent symptomatic cases, refractory lesions and where biopsy may be needed. This can be achieved by the surgical removal of periapical pathological tissue (surgical curettage) and by removing/occluding irritants within the confines of the apical portion of the root canal system and isthmuses (retrograde root resection, root end preparation and retrograde obturation). Endodontic microsurgery combines unsurpassed magnification and illumination using a dental operating microscope and specific micro-instruments that significantly affects case selection, predictability and post-operative healing sequelae. These major advances in surgical technique, instrumentation and materials have occurred over the last twenty years. Supported by research they have not only led to the overall improvement in treatment success but the ability to save what were once considered hopeless teeth