Apicoectomy - Endodontical Surgical Procedure

Abstract

The progress of fundamental medical sciences, of other medical and surgical specialties enabled a fast development pace of modern maxilla-facial surgery. Oro-maxilla-facial surgery bring together science and art in order to prevent, diagnose and cure disease, to reconstitute shapes and restore functions of the oro-maxilla-facial area often by surgery. Apical surgery is a standard surgical procedure including incision of the apex and resection of the apical and periapical diseased site, preceded or not by the correct endodontic treatment and the adequate root canal obturation. Periapical pathology is maintained in an endodontic treatment considered correct, being resolved by endodontic surgery with apicoectomy and avoiding extracting the causal tooth. In this way the area is kept as favorable as possible for future prosthetic works. It is achieved mostly in monoradicular teeth and this intervention is suitable for molars, yet the topography and the morphology of the molars make the surgery more difficult. Oral surgery and endodontics have accumulated a rich experience in maintaining the teeth on the arch for as long as possible. The study material for endodontic case selection, examination and resolving is gathered from the Clinic of Oral and Maxillo-Facial Surgery of the Spiridon Teaching Hospital over a period of two years, from 2014 to 2016; the study group for endodontic therapy and surgery comprises 59 patients. To receive apicoectomy, the tooth and its periodontium should meet certain conditions after apicoectomy, the operated root needs to keep an osseous implantation length equal to two thirds or at least half its initial length. Complex oral rehabilitation of various clinical cases met in dental surgery is a challenge for the dental surgeon due to the various degrees of impairment of all system elements. The emerging malfunction is difficult to diagnose and to treat, asking for dental surgeon�s special experience and clinician skills.