Retrograde RCT (Apicoectomy)

Question 1

Goal

Answer 1

Regrowth. of cementum and PDL

Question 2

Indications of Apico

Answer 2

when standard RCT failed
ineffective resolution of periapical problems
alternative to extraction

Question 3

Contraindications

Answer 3

Unknown cause of RCT failure, re treatment failure, medical concerns, unfavorable crown/root tip ratio, perio concerns, resorption

Question 4

How much of the apex should be amputated

Answer 4

3-4 mm

Question 5

two angles for resection of apex

Answer 5

45* and 90*

Question 6

45* technique

Answer 6

bevel
allows for better visibility
increases risk of residual infection

Question 7

90* technique

Answer 7

less tubules exposes
distributes force evenly

Question 8

What are the 2 commonly recommended root end fillers

Answer 8

MTA
Zinc Oxide
** amalgam has been used**

Question 9

Root end conditioning

Answer 9

Enhances fibroblasts
Citiric acid – new attachment and cementotgenisis. May denature collagen
EDTA - expose collagen and dentin. May interfere with MTA