Peri-radicular Surgery

Question 1

What are the aims of peri-radicular surgery?

Answer 1

Achieve an apical seal

Move existing infection- excision of the apex and curettage.

Question 2

What are the indications for peri-radicular surgery?

Answer 2

Failure of endodontics
- Obstruction of instrumentation
- Root filler error- undefiled, over filled, open apex.
- Lateral root canals
- Poor host tissue response

Apical cyst

Post crowned teeth with endodontic failure.

Lateral perforation.

Question 3

What can you use to remove the apical part of the root?

Answer 3

Rotary bur in an electronic hand piece

Ultrasonic

Question 4

What filling materials are available as a retrograde root filling?

Answer 4

Amalgam

ZOE

MTA

Question 5

What are some the reasons that periradicular surgery fails?

Answer 5

Inadequate seal
- too little apex removed
- Lateral canals
- Extra root or bifid root
- Seal of incorrect shape
- Lateral perforation problem

Inadequate support
- Too much apex removed
- Poor periodontal status
- Excessive occlusal loading
- Apical third fracture

Question 6

How much of the root should be removed during peri-radicular surgery?

Answer 6

3mm

Any more than this and you run the risk of the tooth becoming mobile.