WHEN TO CONSIDER REFERRAL
Although many of the procedures presented in this chapterappear relatively straightforward, endodontic surgery is often complex and difficult to perform. Cliniciansshould carefully Consider the problems before undertaking such surgeries.
Determining the Cause of Root
Canal Treatment Failure Two steps are critical to success, particularly if surgery is being considered: (1) identification of the cause of faililre
and (2) design of the treatment plan. Frequently, surgery is not the best choice but when necessary must be done appropriately. A specialist is better able to identify these causes and approach their resolution. If the cause of the failure cannot be identifieb, these cases must be considered for referral.
In summary, most of the procedures discussed in this chapter require greater training and experience than are provided in an undergraduate dental education program. If the clinician has not had additional postgraduate training and experience, referral must be considered.
1. Grung D, Molven 0, Halse A: Perlaplcal surgery Ina Norwegian county’ hospital: follow-up findings of 477 teeth, 1 £IIIloJ 16:411, 1990. . .
2. Allen RK, Newton CW,’ Brown CE: A statistical analysis of surgical and nonsurgical endodontic retreatment cases, 1 ElldO(lI5:261, 1989. .
3. Houck V et al: Effect of trephination on postoperative pain .and swelling in symptomatic necrotic teeth, Oral Surg Or,,1 Med Oml Path Oral Radiol Ended 90:50i, 2000.
4. Moiseiwitsch JR, Trope M: Nonsurgical root canal ther~py treatment with apparent indications for root-end surgery.’ Ora/ SlIrg Oral Med Oral Path Oral Radio! Endod 86:335, 1998.
5. Danin j.et al: Outcomes of periradlcular surgery in cases with apical pathosis and untreated canals, Oral Sutg Oral Med Oral
Path Oral Radiol Endod 87:227, 1999.
6. Ncaverth EJ, Burg HA: Decompression of large periapical cys- .tic lesrons.J Bndod 8:175,1982.
7. Kvist T, Tut C: Postoperative discomfort associated with surgical and nonsurgical endodontic retreatment, Dent Trm.lmatoI16:71,2000.. ‘
9. Davis W, Oakley J, Smith E: Comparison ‘of the effectiveness of etidocaine and lidocaine as local anesthetic agents during oral surgery, Anesth Prog 31:159, 1984. .
10. Battrum DE, Gutmann JL: Implications, prevention, and management of subcutaneous emphysema during endodonnc treatment, Endod Dent Traumatol 11:109, 1995.
11. Fister J, Gross BD~A histologic evaluation of bone response to bur cutting with and without water coolant, Oral SlIrg Oral , Med Oral PathoI49:105, 1980.
12. Lin LM; Gaengler P, Langeland K: Periradicular curettage, Int Endod 129:220, .1996. “
21. johnson B: Considerations iii-the selection of a root-end fill- – • Ing material, Oral SlIrg Oral Med Oral Pa~1 Oral Radlol Endod 87:398, 1999.
22. Rud J, Rud V, Munksgaard EC: Periapical healing of, mandibular molars after root-end sealing with dentinebonded composite, lnt Endod 134:285, 2001.
23. Fouad A, Rivera E, Walton R: Penicillin as a supplement in resolving the localized acute apical abscess, Oral Oral Med Oral Path Oral Radiol Endod 81-:590, 1996.
24. Fuss Z, Trope M: Root.perfcrattons: classification and treatment choices based on prognostic factors, Endod Dent Traumato
25. Lee Monsef M Torablnelad M Sealing ability of a mineral trioxide aggregate for repair of lateral root perforations, Endod 19:541: 1993:
26. Holland R et al: Minerai trioxide aggregate repair of lateral root perforations, 1 Endod 27:281,2001 •
27. Molven 0, Halse A, Grung II: Incomplete healing (scar tissue) after periapical surgery: radiographic finmngs) to 12 years after treatment 22:264, 1996.
28. Molven 0, Halse A, Grung II: Surgical management of endodontic failures: Indications and treatment results, lilt Dent I 46:33, 1991. fines P et al: Use of the microscope in endodontics: a report based on a questionnaire, I Ended 25:755, 1999.
29. Bahcall J, DiFiore P, P oulakidas T: An endoscopic technique for endodontic surgery, I Endod 25:132, 1999,
30. kankow H, Krasner P: Endodontic applications of guided tissue regeneration in endodontic surgery, J Ended 22:34, 1996.
31. Douthitt, JC, Gutmann J~ Witherspoon D: Histologic assessment of healing after the use of a bioresorbable membrane in the management ofbuccal bone loss concomitant with pcriradlcular surgery, I Endod 27:404, 2001.
32. Rahbaran S et al: Comparison of clinical outcome of periapical surgery in endodontic and oral surgery units of a teaching dental hospital: a retrospective study, Oral Surg Oral Med Oral Pathot Oral Radial Endod 91:700, 2001.