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PubMed2002

Follow-up study of apicectomised anterior teeth.

A retrospective study was carried out on anterior teeth which had undergone apicectomy between 1995 and 1997. More maxillary teeth were treated (94.7%) than mandibular teeth (5.3%). Radicular cyst was the most frequently diagnosed reason for the treatment (47.3%), followed by chronic apical infection/granuloma (44.0%). The overall success rate was 71.9%, while treatment outcome was doubtful in 14.0% of the apicectomised teeth. The presence of pre- or postoperative signs and symptoms did not have any statistically significant effect on the treatment outcome. A higher percentage of roots with retrograde amalgam fillings healed successfully than roots with orthograde fillings, but the difference was not statistically significant (P > 0.05). More lesions classified histopathologically as radicular cysts healed successfully than those classified as granulomas (Fisher exact test, 2-tailed P value = 1.0).

Adolescent↗
PubMed2002

The changing role of the apicectomy operation in dentistry.

Enormous progress has been made in the last quarter of a century in understanding the nature of root canal infection and periapical disease. New techniques and materials may be expected to increase the already high success of conventional root canal treatment. Surgical intervention is required for cases where retreatment has failed or is not an option, and the tooth is to be retained rather than extracted. This article reviews the operation of apicectomy and how this minor oral surgical procedure has evolved. Recent modifications to techniques and materials are likely to improve its success, allowing conservation of previously unsaveable teeth.

Apicoectomy↗
PubMed2002

A new approach to restoring root-end cavity preparation in surgical endodontic procedures--a scanning electron microscopy study.

While many different restorative materials are now available for filling root-end preparations in surgical endodontic therapy, each one has drawbacks. The current study suggests that a flowable composite resin, cured by a high-power curing light in 10 seconds, may be the material of choice. The significance of coating the resected root surface with a dentin-bonding agent is also discussed.

Apicoectomy↗
PubMed2003

Clinical repair of an osseous defect associated with a cemental tear: a case report.

Cemental tears have been described as detachment of cementum caused by trauma or aging. They often result in severe periodontal lesions that may necessitate the extraction of the affected tooth. This case report describes the clinical resolution of a periodontal lesion associated with a cemental tear. A maxillary central incisor was subjected to endodontic treatment twice with no resolution of a deep distobuccal pocket and a palatal sinus tract from its apical region. The preoperative differential diagnosis for the condition present on the tooth included a vertical fracture and a combined periodontal-endodontic lesion. Surgical exploration of the area revealed a cemental tear on the apical third of the tooth. The cementum fragments were removed, root-end resection was performed, and the osseous lesion was treated with an osseous graft and guided tissue regeneration. Clinical examination of the area 1 year after surgery revealed resolution of both the prior pocket and sinus tract. Radiographic examination of the area showed increased radiopacity in the area of the original lesion, suggesting bone fill.

Alveolar Bone Loss↗
PubMed2003

Intentional replantation of endodontically treated teeth: an update.

The IR technique is a clinically successful procedure, so long as the following conditions, as outlined by Niemczyk, are met: 1) Avoid any crushing or scraping contact with the root surface or socket; 2) Root surface must be continually hydrated with tissue culture media (e.g., HBSS); 3) Tooth should be splinted, if indicated; and 4) Soft diet and hygiene instructions must be implemented and reinforced. The IR technique should not be considered a procedure of last resort. Rather, it should be used in situations where conventional apical surgery is difficult or places the patient at risk. The IR technique expands potential treatment alternatives and allows the patient to successfully retain his or her own tooth following treatment.

Apicoectomy↗
PubMed2002

[Evaluation of the height of the apical delta of maxillary anterior teeth. Surgical significance].

It's a study dealing with the apical delta position in the management of peri-apical lesions. The study was carried out from the observation of root canal systems of 150 teeth mainly central, lateral incisors and canines. The study has been bounded by the conservative dentistry and oral surgery departments of the UCAD Dental Institute. It lasted from February to November 2001. We noted that the maximal height of the apical deltas comparison to the apices is 1.6 mm. So, the height of 3 mm section proposed by MEYER during the apicectomies is enough to eliminate the major part of the accessory canals.

Apicoectomy↗
PubMed2003

Healing of periapical lesions with complete loss of the buccal bone plate: a histologic study in the canine mandible.

This study evaluated periapical healing of induced apical lesions with concomitant loss of the buccal bone plate in a dog model using four foxhounds. In an initial surgery, pulp cavities of mandibular premolars were exposed to induce apical lesions. In the same session, the cortical bone covering the buccal root surfaces was surgically removed to simulate buccal bone loss. After radiographic confirmation of the development of apical lesions, sites were reentered for surgical treatment. Following apical and buccal debridement, root-end resection, and root-end filling, sites were subjected to three different treatment modalities: (1) flap readaptation (controls); (2) placement of a collagen membrane covering the apical defect and denuded root surface; or (3) placement of an anorganic bovine bone filler into the apical defect and onto the exposed buccal root surface, with additional application of a collagen membrane. Animals were sacrificed 7 months following the second surgery. Step sections were analyzed histometrically and morphometrically for periapical healing. Sites with membrane + filler showed a statistically significantly lower mean percentage of new bone formation within the former defect compared to both membrane-alone and control sites. No significant differences were found for tissue components deposited on the cut root face across treatment groups. Formation of a continuous thin layer of new cementum covering the exposed dentin surface and root-end filling material was a frequent finding. Analysis of the tissue regeneration on the buccal root aspect as well as the clinical periodontal parameters will be presented in a separate article.

Absorbable Implants↗
PubMed1992

Microscopes in endodontics.

The introduction of microscopes in clinical and surgical endodontics is fairly recent. Potential applications, including removal of fractured instruments, localizing calcified canals, soft tissue management and root-end procedures, are reviewed.

Apicoectomy↗
PubMed1992

Clinical response of hard tissue replacement (HTR) polymer as an implant material in oral surgery patients.

This study evaluated the performance of a synthetic implant material, Hard Tissue Replacement Polymer, for: (1) ease of handling, (2) compatibility with bone and soft tissue, (3) stability of augmentation over time, and (4) development of untoward effects. HTR (a registered trademark of HTR Sciences, a division of United States Surgical Corporation, Norwalk, CT 06856) was implanted into 34 patients by means of five different surgical procedures. The material was found to be easy to manipulate during surgery. Tissue and bone compatibility, defined as absence of inflammation, was present in 32/34 surgical sites (94%). In extraction sites during the 18-month follow-up, no measurable decrease in bone height or width was seen. One patient with a large periodontal endodontic defect developed a post-operative infection necessitating extraction of the tooth. No induction of bone was seen in response to placement of HTR material.

Adolescent↗
PubMed1992

[Lack of healing following adequate endodontic treatment].

When an endodontic treatment is to be redone, generally the X-ray reveals some form of poor or inadequate filling. Most endodontic cases fail because of inadequate endodontic treatment (cleaning, shaping, filling). However, sometimes good clinical treatment isn't followed by healing! This article sums up the possible reasons to consider. In order to improve the success rate of the endodontic treatments, practical hints are given regarding the non-surgical as well as the surgical (re)treatments.

Apicoectomy↗