Surgical Endodontics

Question 1

Basic indications for Surgical Endodontics

Answer 1

Active peri-apical inflammation despite satisfactory endo on tooth
Peri-Apical inflammation with unsatisfactory endo
Peri-Apical inflammation with endo completion impossible
Time constraints

Question 2

Why would one do a surgical amputation of a root end instead of re-doing the endo of a patient that has a poor endo? ( Present with peri-apical inflammation )

Answer 2

Because endo can not be redone
- As the root is completely calcified
Severely curved root canal
Presence of posts in root canal
Presence of small insturment ( file ) in root canal

Question 3

What could possibly prevent the completion of an Root Canal treatment

Answer 3

Foreign bodies into periapical tissue
lateral perforation of floor/canal
Perforation of root
Apical 1/3 root fracture
Dental anomalies ( dens in dente )

Question 4

What is a dens in Dente?

Answer 4

Is rare developmental tooth anomaly characterized by invagination of the enamel organ into the dental papilla that begins at the crown and often extends to the root even before the calcification of the dental tissues.

Question 5

What are some contra-indications for Surgical Endodontics?

Answer 5

All conditions that are considered CI for surgery
Poor endo
coronal leakage
Periodontal tissue
Short roots
Traumatic occlusion
Teeth with apices in close relation to key anatomic structure - mx. sinus, IAN, Mental, incisive , greater palatine Foramina
other teeth

Question 6

Brief Description of the surgical procedure of root resection

Answer 6

Proper clinical and radiographic assessment before surgery
Flap ( choice + design + elevation/reflection )
Intra-bone procedure
Wound closure
Occlusion assessment
Pain control medication
Follow-Up