Retro preparation with retro filling with MTA.

Paraendodontic surgery. Case of paraendodontic surgery of upper second premolar with chronic periapical abscess.

Patient was referred by a colleague due to the presence of periapical lesion and fistula in tooth 15 with a threadable pin. Due to the difficulty of removing the pin while maintaining the structure for a new prosthesis, paraendodontic surgery was chosen, in agreement with patient and indicator.

An apicectomy was then performed with ultrasound retropreparation and retrograde obturation with MTA.

Retro preparation with retro filling with MTA.

In: Sobral et al. Paraendodontic surgery associated with retro-obturation with MTA in treatment of extensive pericopathy: Case report. RDAPO: Digital Journal of the Para Academy of Dentistry.

INTRODUCTION
The periapical infection of endodontic origin occurs due to pulp necrosis, together with host immunosuppression, being the anaerobic gram negative bacteria, fungi and viruses the main responsible microorganisms. Thus, pathologies of endodontic origin have their etiology closely related to microbial contamination of the coronal and root pulp.
Conventional endodontic treatment consists in eliminating microorganisms from the coronal and root pulp regions, and from the periapice, besides determining physical barriers with adequate obliteration of the root canals, effective in preventing microorganisms from reaching the apical and periapical tissues.
However, endodontic treatment, like any other therapy, is subject to iatrogenic events and limitations, such as: bacterial resistance, recontamination, anatomical variability, accidents, and complications.
Thus, the success of endodontic treatment depends on several factors, and in cases of failure, such as inaccessible and persistent periapical lesions, an alternative intervention is required, such as para-endodontic surgery.
CPE comprises a set of procedures, often performed when conventional endodontic treatment fails. Among the indications are: root canal obliteration, apical extrusion of endodontic material, calcification or obstruction by fractured instruments, extensive lesions, root fractures, intraradicular retainers that cannot be removed, anatomical anomalies, and persistent periapical infections.
As mentioned, CPE consists of a set of surgical maneuvers, which range from curettage or apical plasty, apicectomy with or without retrograde filling, and even transurgical filling, and in some cases, all these techniques are used together.

https://www.youtube.com/watch?v=tGj5F1t-8ls&t=71s

https://ferrariendodontia.com.br/reabsorcao-radicular-3/

Retro preparation with retro filling with MTA.