Posterior Endodontic Surgery – A Case Report

Abstract

Objective: Endodontic surgery is a standard procedure which enhances the retention* survival rate of many teeth which can not be treated only endodontically (inaccessibility to the apical part of the root by a coronal approach due to posts, root fractures, separated instruments in root canals, calcified and tortuous root canals, dens in dente, , etc.). Endodontic surgery can be applied both to the anterior and posterior regions on the maxilla and mandibula . In posterior regions the surgical procedure is more difficult due to anatomical conditions (maxillary sinus, mandibular canal, number of root canals, inaccessible posterior oral cavity, etc). Aim: To present a difficult clinical case where endodontic surgery was chosen as the most -convenient method for treatment because by the routine endodontic treatment is not possible to remove a separated instrument in the periapical lesion. Methods: The endodontic treatment was performed on tooth #36, followed by endodontic obturation of the root canal system. In two days an apicoectomy without retrograde filling was performed. Results: One year after the apicoectomy there is complete healing of the periapical lesion with new bone formation and no symptoms in the patient.

Reasons for Extraction of Endodontically Treated Teeth – a Review of Literature

“…Endodontic surgery is considered as a standard procedure which enhances the survival rate of teeth that cannot be treated orthograde because of inaccessibility to the apical region due to posts, root fractures, separated instruments, calcifications, dens in dente, etc. (22). The patients' whishes also play an important role in the decision-making process in teeth with extensive calcifications and cervical resorption (19).…”

The Morphology of Maxillary First and Second Molars, Analyzed by CBCT - a Review of Literature

“…CBCT is considered according to some studies as the most aqurate technique for this purpose (33,34). CBCT allows prior knowledge of the exact relations between the anatomical structures (35). CBCT evaluation before the endodontic treatment can point to proper treatment decision because it allows evaluation of the exact morphology of the root canal system and of the preoperative extend of existing periapical lesions (36,37).…”

Cone Beam Computed Tomography as a Diagnostic Tool in Endodontics- A Review of the Literature

“…The information from the CBCT-scan and the prior knowledge of the exact relations between the anatomical structures allow performing of surgical endodontic procedures in the posterior region, which is considered to be more difficult due to anatomical conditions (maxillary sinus, mandibular canal, number of root canals, inaccessible posterior oral cavity, etc.) [48].…”