Modern surgical endodontics: Acomprehensive clinical approach

Auteurs: Kawther bel Haj Salah , Ghada Bouslema , Imene Gnaba, Souha Ben Youssef

Abstract

Introduction

Endodontic microsurgery, combining advanced technology and biological principles, offers predictable healing of complex endodontic lesions. This technique has greatly improved outcomes, particularly for apical lesions due to necrosis or incomplete orthograde treatments. This paper illustrates the enhanced prognosis of endodontic microsurgery through a clinical case.

Observation

A 49-year-old female patient presented with pain in tooth 11, which had no prior endodontic treatment. Periapical radiographs and preoperative CBCT revealed a radiolucent lesion (Estrella PAI score: 5D) with buccal cortical bone destruction. Initial root canal treatment failed to resolve the lesion, necessitating endodontic microsurgery. Follow-up confirmed complete healing and reossification of the lesion.

Discussion

Endodontic surgery is indicated for persistent lesions, complex anatomies, or when retreatment is unfeasible. It is also advantageous for preserving prosthetic restorations. Preoperative CBCT ensures accurate planning, while modern tools like operating microscopes and ultrasonic instruments enhance precision and outcomes. Success depends on healed tissues, bone regeneration, and factors like lesion size, tooth location, and restoration quality. Meticulous planning and execution are critical for optimal results.

Conclusion

Technological advancements have revolutionized endodontic surgery, making it a precise, predictable, and effective treatment. Innovations such as CBCT, microsurgical instruments, and bioceramics ensure high success rates and establish the procedure as a reliable therapeutic option.

télécharger en pdf