Periradicular surgery

Question 1

What are the aims of Peri-radicular surgery?

Answer 1

1. Achieve apical seal
2. Remove existing infection (via curettage or excision of apex)

Question 2

What are the indications for Peri-radicular surgery? 5 failures of endo

Answer 2

1. Obstruction to instrumentation i.e. broken instrument
2. Root filler error or problem i.e underfilled
3. Miscellaneous i.e.e lateral root canals
4. Pathology i.e. apical cyst
5. Post Crown teeth with endo failure
6. Lateral perforation

Question 3

What is the Apicectomy technique?

Answer 3

1. LA
2. Raise a flap accoridng to flap design (semilunar or traingular)
3. Prep root end using ultrasonic or rotary bur
4. Place retrograde root filling
5. Close flap

Question 4

What are the ideal retrograde root filling materials?

Answer 4

• Amalgam
• ZOE
• MTA (mineral trioxide aggregate)

Question 5

Causes of failure of peri-radicular surgery?

Answer 5

1. Inadequate seal
2. Inadequate support (to much apex removed)
3. Miscellanous (poor healign response)