Periradicular surgery

In the dental specialty of endodontics, periradicular surgery is surgery to the external root surface. Examples of periradicular surgery include apicoectomy, root resection, repair of root perforation or resorption defects, removal of broken fragments of the tooth or a filling material, and exploratory surgery to look for root fractures.[1]

Symptoms may be due to infection in the periradicular tissue around a root-treated tooth, which can impede healing of the tooth after conventional root canal treatment.[2] After removing the pulp, the aim of endodontic treatment is to seal the pulpal space to prevent further bacterial contamination and allow healing of the periradicular tissue. Success rates for root-canal treatment range from 47 to 97 percent; failures may be due to spaces in the root-canal filling, a root filling which is too short or a preexisting periapical lesion.[3]

Treatment options are nonsurgical root-canal re-treatment or periradicular surgery. Although accessing and cleaning the pulp chamber and canals would be easier with the former, it is contraindicated in some patients.[2]

The stages of periradicular surgery are:

  1. Local anaesthesia
  2. Flap design
  3. Bone removal
  4. Curettage
  5. Apicectomy
  6. Retrograde preparation and filling
  7. Wound closure
  1. ^ "Endodontists' Guide to CDT 2017" (PDF). American Association of Endodontists. 2017. pp. 13–14. Retrieved 2020-03-14.
  2. ^ a b Cite error: The named reference :6 was invoked but never defined (see the help page).
  3. ^ Ng, Y.-L.; Mann, V.; Rahbaran, S.; Lewsey, J.; Gulabivala, K. (2007-10-11). "Outcome of primary root canal treatment: systematic review of the literature – Part 2. Influence of clinical factors". International Endodontic Journal. 41 (1): 071011095702005––. doi:10.1111/j.1365-2591.2007.01323.x. ISSN 0143-2885. PMID 17931388.