Apicectomy in lower canine. Case report. Patient was indicated for paraendodontic surgery in the right mandibular canine, after treatment and retreatment performed without success to repair periapical lesion.
Patient did not report any symptoms. Radiography and CT scan revealed a large periapical radiolucent image that was not repaired after satisfactory retreatment by a specialist. The proposed treatment was apicectomy, using paraendodontic surgery.
Case conducted by students Miquele Viana and Bruna Regiani, from the specialization in endodontics of APCD Bragança Pta.
Apicectomy in: Leonardi et al. Parendodontic surgery: Evaluation of different techniques for performing apicectomy. RSBO v. 3, n. 2, 2006
Summary
Apicectomy is a surgical act in which the apical resection of the root is performed. It is indicated in cases of torn roots that prevent a conventional treatment, perforations of the root in the apical third, presence of unobtained ramifications and fractured endodontic instruments, whose treatments were unable to solve the problem via the root canal. Endodontic treatment failure usually occurs due to the presence of microorganisms in the depths of the root canal system that resisted cleaning and shaping procedures. The aim of this study was to perform a literature review on factors related to technical resources for performing apicectomy and anatomical and histological conditions. Through the literature review, it could be concluded that several elements influence the success after performing apicectomy, namely: the root region in which the cut is made, the use of burs or laser in its confection and the involvement of apical anatomical variations.
Introduction
Parendodontic surgery is a safe and appropriate procedure for the treatment of teeth with periapical lesions that do not respond to conventional endodontic treatment or when retreatment is not possible. The success of such surgery has been reported in 80% of cases in recent years.
This high rate may be related to new surgical techniques, new surgical instruments, new ultrasonic tips and the improved quality of retroobturator materials.
The evaluation criteria are usually limited to clinical and radiographic conditions, although few studies have considered the histological results in cases of failure. During the procedure, the apex is usually cut with surgical burs at high speed, and the surface of this cut should appear smooth and flat, without the presence of steps or irregularities, which act as irritants or stimulate dentin resorption during the repair process.
Apicectomy
