Endo Surgery Flashcards
What are some indications for Periradicular Surgery?
- Inability to debride apical canal
- Anatomic Variation
- Obstruction
- Iatrogenic Issue
- Gross GP overextension
- Perforation
- Progressive root resorption
- Persistent post-op disease
- Biopsy is necessary
Describe the Traiangular Flap Design?
Single Vertical Release
- Between eminences
- Adequate access
Tisue Reflection
- Begin in vertical release
- Undermine laterally
- Avoid sulcular reflection (Preserves root-attached tissues)
Why would you want to use this instrument for root end surgery?
Avoid Air Emphysema
Describe the Ochsenbein - Luebke Flap…
Where are most anatomic variations in the root?
Apical 3 mm
Why resect the apex?
- Most anatomic variations in apical 3 mm
- Eliminate diseased root, resorption, fracture
- Remove operator errors
- Gain access to canal system
- Allows evaluation of root surface
- Allows access to remove lesion
- Allows access to improve apical seal
- General rule: resect 3 - 4 mm
What is the ideal bevel?
0°
Minimize angle as anatomy, access permiting…
Describe the preparation process for root-end surgery?
- Use Ultrasonics
- 3 mm deep along long-axis of root
- Stain root end (PDL, Canals, Isthmus, Fracture)
- Always prepare the isthmus
What is going on here?
Root-End Preparation…Prepare the Isthmus
What is the goal of a Root-End Filling?
Seal all apical portals of exit
What are some material requirements of a Root-End Filling?
- Biocompatible
- Nonresorbable
- Impervious to breakdown by tissue fluids
- Capable of being well-adapted
What is a good Root-End Filling Material?
Portland Cement
- Tricalcium silicate
- Traicalcium aluminate
- Triclcium oxide
- Silicate oxide
2.5 - 4 hour set
Outstanding seal
Biocompatible
Shows cementum overgrowth
What is a “Super” Root-End Filling Material?
Super EBA
Powder
- ZnO - 60%
- Alumina - 37%
- Natural Resin - 3%
Liquid
- O-ethoxybenzoic acid - 62.5%
- Eugenol - 37.5%
What is an alternative Root-End Filling Material?
IRM
