Peri-radicular surgery

Question 1

Aims of peri-radicular surgery

Answer 1

Achieve apical seal

Remove existing infection

Question 2

Indications for peri-radicular surgery?

Answer 2

Failed endo
- obstruction to instrumentation
- broken instrument
- root dilaceration
- root fracture
- over/underfilled
- open apex
- poor host tissue response

Pathology
- radicular cyst
- perforation

Question 3

Flap used for peri-radicular surgery?

Answer 3

Semilunar flap

Triangular flap

Rectangular flap

Question 4

How is the root end prepped in radicular surgery?

Answer 4

Rotary bur with an ultrasonic

Question 5

What materials can be used as retrograde root filling?

Answer 5

Amalgam

ZOE

MTA

Question 6

Causes of failure of radicular surgery?

Answer 6

Inadequate seal
- extra rot or bifid root
- too little apex removed
- lateral canals / perforations

Inadequate support
- too much apex removed
- poor perio status
- excessive occlusal loading
- apical third fracture

Poor healing