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A self retaining apicoectomy retractor suitable for use under local or general anaesthesia in the upper and lower premolar, canine or incisor regions is described. Constructed from an Ash no. 1 rubber dam clamp the device can be cheaply and easily constructed from materials available in most orthodontic or dental laboratories.
The apicoectomy in molars is a well accepted, though not so popular, method for the treatment of molars with chronic inflammatory periapical disease. This paper is about the indications as well as the surgical technique of the operation. The procedure is connected with very good clinical results and no serious complications, therefore is suggested for wider clinical application.
The optimal way to address endodontic failures is to retreat the root canal system first and only then to consider apical surgery. Unfortunately, in practice, it is often not done in this way. Patients are subjected to apical surgery, without any attempts at retreatment. A series of cases is presented illustrating failures of apicoectomy and successful endodontic retreatment.
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This article introduces a new method of combining the oral surgery and oral prosthesis into one operation. This method can greatly shorten treatment time. It is used to treat a badly decayed tooth with an apical lesion and to repair it with a post crown at the same time. Since March 1975 more than 20 cases have been treated in this manner with a favorable outcome.
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The effect of resection of the apical part of the root before replantation upon periodontal and pulpal healing was studied in 7 green Vervet monkeys (Cercopithecus aethiops) using teeth with incomplete and complete root formation. Maxillary central incisors, mandibular lateral incisors and first and second mandibular molars were used in this experiment. On one side, the tooth was extracted and replanted with an intact root while the contralateral tooth had 2 mm of the apex resected for the purpose of facilitating pulpal repair and eliminating resorption in the resorption-prone region of the root. The replanted teeth were examined histologically 8 weeks after replantation. The histometric analysis revealed no significant difference in periodontal healing between teeth with or without apical resection. With regard to pulpal healing, apical resection was found to lead to significantly less vital pulp tissue in teeth with immature root formation. A similar, but not significant difference was found for mature teeth. Based on these findings, it could not be recommended that apices be resected prior to replantation in order to improve pulpal repair.
OBJECTIVE: To histologically assess the efficacy of various retrofilling materials in apical surgery. STUDY DESIGN: The pulps of mandibular premolars in seven beagle dogs were infected; this resulted in periapical lesions. Apical surgery was performed without disinfection of the root canals. Super EBA (Harry J. Bosworth Co., Skokie, III.), two formulations of glass ionomer cement, amalgam with varnish, IRM,(Caulk Co., Ltd., Densply International, Milford, Del.) and a light-cured composite resin were the retrofilling materials used. Roots infected and apicoectomized without retrofilling were positive controls. After 6 months the dogs were killed. The experimental roots and surrounding apical tissues were prepared and histologically examined and relative percentages of bone and inflammation were calculated. RESULTS: Super EBA was consistently the best. In overall periapical condition, Super EBA was statistically superior to all materials except IRM. IRM was superior to the glass ionomer cements but not the other materials. As to percentage of bone, Super EBA was the best overall; it was superior to glass ionomer, composite resin, and the positive control but not different from amalgam or IRM. When comparing remaining numbers of inflammatory cells, Super EBA was superior with the lowest number of inflammatory cells present. CONCLUSION: Although not statistically different from IRM, Super EBA was consistently the best retrofilling material tested when compared with all retrofilling materials studied.
Root-end cavities have traditionally been prepared by means of small round or inverted cone burs in a micro-handpiece. Since sonically or ultrasonically driven microsurgical retrotips became commercially available in the early 1990s, this new technique of retrograde root canal instrumentation has been established as an essential adjunct in periradicular surgery. At first glance, the most relevant clinical advantages are the enhanced access to root ends in limited working space and the smaller osteotomy required for surgical access because of the various angled designs and small size of the retrotips. However, a number of experimental studies comparing root-end preparations made with microsurgical tips to those made with burs have demonstrated other advantages of this new technique, such as deeper cavities that follow the original path of the root canal more closely. The more centered root-end preparation also lessens the risk of lateral perforation. In addition, the geometry of the retrotip design does not require a beveled root-end resection for surgical access thus decreasing the number of exposed dentinal tubules. A controversial issue of sonic or ultrasonic root-end preparation is the formation of cracks or microfractures, and its implication on healing success. The present paper reviews experimental and clinical studies about the use of microsurgical retrotips in periradicular surgery and discusses many issues raised in previous papers.