Category Archives: Principles of Endodontic Surgery

Principles of Endodontic Surgery

CHAPTER OUTLINE  DRAINAGEOF AN ABSCESS PERIAPICALSURGERY Indications Anatomic Problems Restorative Considerations Horizontal Root Fracture Irretrievable Material in Canal Procedural Error large Unresolved l,esions After Root Canal Treatment • Contraindlcations (or Cautions) Unidentifie.d Cause of Treatment Failure When Conventional Root Canal Treatment is Possible Simultaneous Root Canal Treatment and Apical Sur

Contraindications (or Cautions)

Contraindications (or Cautions) if othe options are available, periapical surgery may no! referred choice (Box] 7-3).Cllidcnti(ictf CUIIW IIf trcut nunt fuirWt Relying on surgery to try to correct all root canal treatment failures could be .labeled indiscriminate. An important consideration is to first, identify the cause of filllure.vthcn S(,COllcC design an appropriate corrective treatment plan. Usually. re


Indications The success of apical surgery varies considerably, depending on the reason for and nature of the procedure. With failed root canal tment, often retreatment is not possible or a better result cannot be achieved by a coronalpproach.’ If the cause of the failure cannot be identified, surgical exploration may be necessary (Fig. 17-1). On occasion an unusual entity in the periapical region require


PERIAPICAL SURGERY Periapical (i.e., periradicular) surgery includes resection of a portion of the root that contains undebrided or unobturated (or both) canal space. It can also involve reverse filling and sealing of the canal when conventional root canal treatment is not feasible. It is often performed inconjunction with apical curettage for reasons explained  later in this chapter.


DRAINAGE OF AN ABSCESS Drainage releases. purulent or hemorrhagic transudates and exudates from a focus of liquefaction necrosis (i.e., abscess). Draining the abscess relieves pain, increases circulation, and removes a potent irritant. The abscess may be confined to bone or may have eroded through bone and periosteum to. invade soft tissue. Managing these i:’.lraoral or extraoral swellings by incision fo