Apicoectomy for Periapical Lesion Treatment after Post Endodontic Failure on First Maxillary Premolar (Case Study)

Abstract

Introduction. Factors that cause failure of endodontic therapy include incomplete cleaning and shaping of root canals and unhermetic obturation. Endodontic failure can lead to periapical lesions. Apicoectomy is one of endodontic surgery treatment choice to preserving the tooth with endodontic treatment failure. Aim. The aim of this report was to show that in cases of failure of root canal treatment could be treat without extraction, however there was an alternative treatments such as apicoectomy that could be used to preserve the tooth and its function in the oral cavity.Case. A male 32 years old patient came to dentist with persistent pain on upper left first premolar. The tooth had been endodontically treated for ten years. Clinical examination tooth #24 had porcelain fused to metal on it, percussion test (+), bite test (+), pain on palpation. Radiographic examination showed that tooth #24 had fabricated post without gutta percha obturation on apical third. There was 3 mm round periapical lesion on the distal side of the tooth. Procedure Apicoectomy and retrograde filling with Mineral Trioxide Aggregate (MTA) and bone graft was performed to eliminate that periapical lesion. Conclusion Apicoectomy is one of main choice to preserve post endodontic tooth with periapical lesion and post core crown on it, as long as possible in oral cavity Keywords : Apicoectomy, Periapical lesion, Post endodontic treatment failure