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PubMed1992

Surgical management of endodontically treated teeth.

Surgical endodontics has become an important treatment modality in modern dentistry. The evolution and development of this modality has suffered from decades of empiricism, as techniques, concepts, and root-end filling materials were advocated without supporting scientific evidence. The techniques and concepts of periodontal surgery and oral and maxillofacial surgery were long assumed to directly apply to endodontic surgery. Evidence now suggests that certain procedures adopted from other specialties are not indicated for surgical endodontics and, in fact, may be counterproductive. During the past year, the most important developments have emerged in the area of surgical wound healing as it relates to soft tissue management procedures. New techniques and concepts that enhance rapid wound healing and decrease untoward postsurgical sequelae have been proposed.

Animals↗
PubMed2004

Contemporary endodontic surgery.

During the past decade, endodontics has seen a dramatic shift in the application of periradicular surgery and the role it plays in endodontic treatment. With the introduction of enhanced magnification, periradicular ultrasonics and other associative technologies, teeth that might otherwise be extracted now have a chance for retention. This article describes the role of these advances in contemporary endodontic surgery.

Humans↗
PubMed2005

[Endodontic surgery (apicoectomy)--success rate of more than 90% using dental operating microscope and ultrasonic tips].

The main cause of root canal treatment failure is presence of bacteria in the root canal. Surgical endodontic retreatment is indicated as a valuable treatment choice for failed endodontic treatment. The aim of the article is to describe the advantages of a new technique for apicoectomy using dental operating microscope and ultrasonic tips in comparison to the traditional technique. Precise root end resection with minimal or no bevel and accurate preparation of the root end cavity to the depth of 3-4 mm allows minimal bone removal and reduces procedural accidents such as perforation of the lingual canal wall. Zink oxide eugenol based materials allow sealing of the retrograde preparation adequately to prevent bacteria and toxins to penetrate the periradicular tissues. Literature review demonstrates success rate to above 90% when employing dental operating microscope and ultrasonic tips for retrograde cavity preparation.

Aluminum Compounds↗
PubMed2005

Periapical surgery using the ultrasound technique and silver amalgam retrograde filling. A study of 71 teeth with 100 canals.

INTRODUCTION: Periapical surgery using ultrasound allows the treatment of root canals of difficult access, with the sacrifice of little root tissue. As a result, periapical disorders which were condemned to treatment failure in the past can now be dealt with successfully. MATERIAL AND METHODS: In 71 teeth presenting 100 root canals treated with ultrasound and subjected to retrograde filling with silver amalgam, the course and short-term success of management was evaluated in relation to lesion size, the magnitude of apical resection, and the size of the retrograde filling cavity. The duration of follow-up was one year, with post-treatment controls after 6 and 12 months. RESULTS: After 6 months, the percentage clinical and radiological success was 92% and 58%, respectively. One year after periapical surgery the corresponding percentages were 95% and 80%. Global success after 6 months was 63%, versus 84.2% after 12 months. No statistically significant relation was observed between treatment success and the size of the periapical lesion, the amount of apex resected, or the size of retrograde filling. CONCLUSION: Periapical surgery using ultrasound and retrograde filling with silver amalgam affords a high success rate after 12 months.

Adolescent↗
PubMed2005

[Periotest-analysis in penradicular surgery: preliminary results of a clinical-prospective study].

The two objectives of the present study were: to assess the healing after periradicular surgery using the Periotest device, and to compare the recorded Periotest values with the healing category determined after a one-year follow-up using radiographic and clinical criteria. In 43 patients with periradicular surgery, Periotest values could be recorded pre- and postoperatively, as well as after six and twelve months. Cases with a successful healing, as determined at the one-year follow-up, demonstrated a continuous decrease of the Periotest values over time, whereas one-year failures showed increasing Periotest values over the study period. In control teeth, the Periotest values remained unchanged for the whole study period. It appears that the Periotest measurements correlate with the postoperative healing mode following periradicular surgery, and therefore, allow an additional assessment of the healing outcome.

Adult↗
PubMed1992

Intentional replantation of a removable partial denture abutment tooth: a case report.

Intentional tooth replantation is a last-resort procedure, recommended only when all other techniques, short of tooth extraction, have been exhausted or are impractical. Although most endodontic textbooks describe the procedure, and many reports of intentional replantation have appeared in the dental literature, none have reported use of the technique to retain a removable partial denture abutment tooth. This article presents such a case and the rationale for the decision to intentionally replant. Eighteen-month follow-up clinical and radiographic results are presented.

Bicuspid↗
PubMed2006

[Periradicular surgery with endoscopy--a clinical prospective study].

Using an endoscope in periradicular surgery provides an impressive optical enlargement and may lead to better clinical diagnostics and a high rate of success. Aims of this investigation were examining this hypothesis as well as detecting influencing factors. In 2002 and 2003, 114 teeth of 91 patients were root-end resected using endoscope. Before surgery, the tooth, number of resected root-ends, content of root channels, clinical diagnosis and moment of surgery were recorded. Patients were controlled one year after surgery and success was evaluated as a summary of clinical and radiological findings. Four patients did not reappear for the control examination. Out of 110 teeth, treatment was successful in 91.8% and failed in 7.3%. 0.9% could not be classified. Statistically, more failures were noted after periradicular surgery in molars. The rate of success increased during the study by means of a learning curve. The results confirm the hypothesis that where using an endoscope periradicular surgery is highly successful.

Adolescent↗
PubMed2005

Combined endodontic therapy and surgery in the treatment of dens invaginatus Type 3: case report.

An accurate understanding of the morphology of the root canal system is a prerequisite for successful root canal treatment. Invaginated teeth have a complex root canal configuration that cannot be instrumented effectively and should be treated by both endodontic therapy and surgery. A case of dens invaginatus Type 3 in a maxillary lateral incisor with a periapical lesion and its successful treatment by these combined methods is reported.

Aluminum Compounds↗
PubMedDate not supplied

Comparison of apexification with mineral trioxide aggregate and calcium hydroxide.

PURPOSE: The aim of this study was to compare mineral trioxide aggregate (MTA) with calcium hydroxide [Ca(OH)2] clinically and radiographically as materials used to induce root-end closure in necrotic permanent teeth with immature apices (apexification). METHODS: Fifteen children, each with at least 2 necrotic permanent teeth requiring root-end closure (apexification), were selected for this study. All selected teeth were evenly divided into 2 test groups. In group 1, the conventional calcium hydroxide apexification (control) was performed, whereas in group 2, the MTA apexification (experimental) was done. The children were recalled for clinical and radiographic evaluations after 3, 6, and 12 months. RESULTS: The follow-up evaluations revealed failure due to persistent periradicular inflammation and tenderness to percussion detected at 6 and 12 months postoperative evaluation in only 2 teeth treated with Ca(OH)2. The remaining 13 teeth appeared to be clinically and radiographically successful 12 months postoperatively. None of the MTA-treated teeth showed any clinical or radiographic pathology. CONCLUSIONS: Mineral trioxide aggregate showed clinical and radiographic success as a material used to induce root-end closure and is a suitable replacement for calcium hydroxide for the apexification procedure.

Aluminum Compounds↗
PubMed2006

Twenty-year follow-up of an unconventional intentional replantation.

For many years, intentional replantation has been a treatment option for pulpless teeth and an effective strategy for teeth that would be difficult, if not impossible, to treat using traditional root canal therapy. The preservation of cell vitality in the periodontal ligament, the removal of all tissue debris and irritating substances from the root surface, achievement of a good apical seal and reinforcement of the crown structure are critical in ensuring normal function of the reimplanted tooth. In this article, we report on an unconventional intentional replantation of a mandibular second molar to relieve continuing symptoms. Retrograde fillings were placed in the second molar and the coronal pulp chamber was sealed with amalgam. No endodontic therapy was carried out either during or after the procedure. After 20 years, the patient was asymptomatic, the tooth was still functional and a recall intraoral periapical radiograph showed an intact periodontal ligament space and lamina dura with no evidence of gross root resorption or ankylosis.

Follow-Up Studies↗
PubMed1991

[Use of the stereo-microscope in endodontic surgery].

The authors present several significant photographs of the apical anatomy of a tooth made using a stereo-microscope in the course of surgery. The authors generally use the stereo-microscope from the time of preparation of the apex to the retrograde filling. One of the changes which the authors have brought to traditional surgical procedures, the use of endodontic cement to improve the amalgam seal is illustrated. It consists of a modification which they introduced into their practice more than six years ago and even though it may be a simple clinical technique to use, it assured a significant long-term improvement in the cases treated.

Apicoectomy↗
PubMed1991

Surgical endodontic and retrograde procedures.

This article reviews the recent literature on endodontic surgery and root end filling materials. Root end filling materials have been studied extensively during the period of this review. The materials that have proved to consistently seal the apex in both leakage and success studies are the reinforced zinc oxide-eugenol cements such as IRM (The L.D. Caulk Co., Milford, DE) and SuperEBA (Harry J. Bosworth Co., Skokie, IL) cement. Articles on treatment planning and surgical armamentaria are also reviewed. Two textbooks and 21 journal articles are cited.

Animals↗