Apical surgery Flashcards
what are some other name for apical surgery ?
- Apicectomy
- Root end surgery
- Endodontic surgery
what are the different classifications of endodontic surgery ? (9)
1 Incision and Drainage - to relieve pain =LA and massage
2 Periapical surgery - usually failed rct, when going in we remove root end(resect) and remove inflammatory tissue then root fill root end (retroprep and retrofilling) close flap done and let healing
3 Perforation / Resorption repair=
open up flap and identify perforation with GIC
4 Root resection - PA legion thats limited to one of roots on multi-rooted tooth and for whatever reason you can’t get that infection cleared ie. fractured instrument or blockage = we would cut that root away
5 Diagnostic surgery - we don’t know whats going on - open flap up - and see whats the problem = con as teeth more likely will need extraction
6 Hemisection - rare= cutting tooth in half
7 Trephination - creating hole in bone to encourage healing
8 Decompression - good - used when we have large legion in anterior region in mouth - where we considering undertaking more conventional PA surgery - we want to shrink legion down before you go to the second surgerical procedure = decompression involves putting a surgical drain in the middle of a large cystic legion - by draining out the cystic fluid through the surgical drain (surgical drain left in pts mouth for 2-3 weeks which theyre then given syringe to irrigate by washing out infection = you get a degree of marsupulisation = this makes surgery far more easier when you’re trying to remove the rest of the granulation ) sometimes surgery isn’t needed when decompression done
9 Intentional Reimplantation - thats where endodontic tx is too difficult to do and the tooth is extracted as atraumtically as possible -its root filled and then reimplanted - has very limited implications
what is important to not when analysing radiographs for apical surgery ?
- are there any anatomical features that may be in the way eg. in lower 5 6 area = mental foramen
