Apicoectomy indications and procedure

There are multiple treatment options for difficult to treat endodontically compromised teeth or for teeth with failed endodontic treatment. Apicoectomy (surgical root canal) is an effective treatment in these cases. The appropriate treatment for some failed endodontic procedures is retreatment. Treatment options for a tooth with a diseased apex may include treatment with MTA, extraction, or apicoectomy. Some compromised teeth with no apical disease may require close monitoring only. Factors in the decision making process include the radiographic appearance of the tooth, health of the apex, and previous treatments. When apicoectomy is the chosen treatment, the procedure requires specific equipment due to the small area of access to the apex. MTA or other bioceramic materials are the preferred apical fill products. Performing a successful apicoectomy procedure requires accurate location of the apex, removal of an adequate amount of the apex, appropriate cleaning, adequate apical fill, and appropriate closure. Case presentations will be provided.