Abstract
In many cases, modern surgical retreatment technique is a realistic treatment option with a predictable and successful outcome. The main objective with surgical retreatment is to eliminate and prevent bacterial infection in the root canal system from causing an inflammatory reaction in the periradicular tissue. This chapter provides an overview of possible indications and contraindications for surgical retreatment from a technical, biological, anatomical, and medical perspective.
The concept of minimal invasive microsurgical approach is the state-of-the-art for surgical retreatment. It requires certain techniques, instruments, and materials. Furthermore, and perhaps most importantly, it requires magnification and illumination either through an operating microscope or loupes equipped with head-lights.
A basic prerequisite for successful treatment is the diagnosis, case selection, and treatment planning. This is particularly important since the primary treatment has failed, and consequently, the case may pose particular difficulties, which is exemplified in the chapter.
It ought … to be understood that no one can be a good physician who has no idea of surgical operations, and that a surgeon is nothing if ignorant of medicine.
—Guido Lanfranchi
Chirurgia Magna (1296, printed 1479).
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Shetzer FC, Shah SB, Kohli MR, Karabucak B, Kim S. Outcome of endodontic surgery: a meta-analysis of the literature—part 1: Comparison of traditional root-end surgery and endodontic microsurgery. J Endod. 2010;36(11):1757–65.
Tsesis I, Rosen E, Taschieri S, Telishevsky Strauss Y, Ceresoli V, Del Fabbro M. Outcomes of surgical endodontic treatment performed by a modern technique: an updated meta-analysis of the literature. J Endod. 2013;39(3):332–9.
Iqbal MK, Kratchman SI, Guess GM, Karabucak B, Kim S. Microscopic periradicular surgery: perioperative predictors for postoperative clinical outcomes and quality of life assessment. J Endod. 2007;33(3):239–44.
Penarrocha M, Garcia B, Marti E, Balaguer J. Pain and inflammation after periapical surgery in 60 patients. J Oral Maxillofac Surg. 2006;64(3):429–33.
Ray HA, Trope M. Periapical status of endodontically treated teeth in relation to the technical quality of the root filling and the coronal restoration. Int Endod J. 1995;28(1):12–8.
Tronstad L, Asbjornsen K, Doving L, Pedersen I, Eriksen HM. Influence of coronal restorations on the periapical health of endodontically treated teeth. Endod Dent Traumatol. 2000;16(5):218–21.
Ng YL, Mann V, Gulabivala K. A prospective study of the factors affecting outcomes of nonsurgical root canal treatment: part 1: periapical health. Int Endod J. 2011;44(7):583–609.
Abbott PV. Incidence of root fractures and methods used for post removal. Int Endod J. 2002;35(1):63–7.
Altshul JH, Marshall G, Morgan LA, Baumgartner JC. Comparison of dentinal crack incidence and of post removal time resulting from post removal by ultrasonic or mechanical force. J Endod. 1997;23(11):683–6.
McMullen AF III, Himel VT, Sarkar NK. An in vitro study of the effect endodontic access preparation and amalgam restoration have upon incisor crown retention. J Endod. 1990;16(6):269–72.
Mulvay PG, Abbott PV. The effect of endodontic access cavity preparation and subsequent restorative procedures on molar crown retention. Aust Dent J. 1996;41(2):134–9.
Nair PN. On the causes of persistent apical periodontitis: a review. Int Endod J. 2006;39(4):249–81.
Wang J, Jiang Y, Chen W, Zhu C, Liang J. Bacterial flora and extraradicular biofilm associated with the apical segment of teeth with post-treatment apical periodontitis. J Endod. 2012;38(7):954–9.
Ricucci D, Siqueira JF Jr. Apical actinomycosis as a continuum of intraradicular and extraradicular infection: case report and critical review on its involvement with treatment failure. J Endod. 2008;34(9):1124–9.
Stockdale CR, Chandler NP. The nature of the periapical lesion—a review of 1108 cases. J Dent. 1988;16(3):123–9.
Nair PN. New perspectives on radicular cysts: do they heal? Int Endod J. 1998;31(3):155–60.
Wood NK. Periapical lesions. Dent Clin N Am. 1984;28(4):725–66.
Natkin E, Oswald RJ, Carnes LI. The relationship of lesion size to diagnosis, incidence, and treatment of periapical cysts and granulomas. Oral Surg Oral Med Oral Pathol. 1984;57(1):82–94.
Lalonde ER. A new rationale for the management of periapical granulomas and cysts: an evaluation of histopathological and radiographic findings. J Am Dent Assoc. 1970;80(5):1056–9.
Ramachandran Nair PN, Pajarola G, Schroeder HE. Types and incidence of human periapical lesions obtained with extracted teeth. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1996;81(1):93–102.
Simon JH. Incidence of periapical cysts in relation to the root canal. J Endod. 1980;6(11):845–8.
Fayad MI, Nair M, Levin MD, Benavides E, Rubinstein RA, Barghan S, Hirschberg CS, Ruprecht A. AAE and AAOMR joint position statement: use of cone beam computed tomography in endodontics 2015 update. Oral Surg Oral Med Oral Pathol Oral Radiol. 2015;120(4):508–12.
Kim S, Kratchman S. Modern endodontic surgery concepts and practice: a review. J Endod. 2006;32(7):601–23.
Pogrel MA. Damage to the inferior alveolar nerve as the result of root canal therapy. J Am Dent Assoc. 2007;138(1):65–9.
Molven O, Halse A, Grung B. Incomplete healing (scar tissue) after periapical surgery—radiographic findings 8 to 12 years after treatment. J Endod. 1996;22(5):264–8.
Corbella S, Taschieri S, Elkabbany A, Del Fabbro M, von Arx T. Guided tissue regeneration using a barrier membrane in endodontic surgery. Swiss Dent J. 2016;126(1):13–25.
Vertucci FJ. Root canal anatomy of the human permanent teeth. Oral Surg Oral Med Oral Pathol. 1984;58(5):589–99.
Kim E, Song JS, Jung IY, Lee SJ, Kim S. Prospective clinical study evaluating endodontic microsurgery outcomes for cases with lesions of endodontic origin compared with cases with lesions of combined periodontal-endodontic origin. J Endod. 2008;34(5):546–51.
Skoglund A, Persson G. A follow-up study of apicoectomized teeth with total loss of the buccal bone plate. Oral Surg Oral Med Oral Pathol. 1985;59(1):78–81.
Malamed SF. Medical emergencies in the dental office. 5th ed. St. Louis: Mosby; 2000. p. 41–4.
Tsesis I. Complications in endodontic surgery. 2014. p. 153–64. Springer-Verlag Berlin Heidelberg;2014
Setzer FC, Kohli MR, Shah SB, Karabucak B, Kim S. Outcome of endodontic surgery: a meta-analysis of the literature—Part 2: Comparison of endodontic microsurgical techniques with and without the use of higher magnification. J Endod. 2012;38(1):1–10.
Velvart P, Peters CI. Soft tissue management in endodontic surgery. J Endod. 2005;31(1):4–16.
Vickers FJ, Baumgartner JC, Marshall G. Hemostatic efficacy and cardiovascular effects of agents used during endodontic surgery. J Endod. 2002;28(4):322–3.
von Arx T, Jensen SS, Hanni S. Clinical and radiographic assessment of various predictors for healing outcome 1 year after periapical surgery. J Endod. 2007;33(2):123–8.
Lamb EL, Loushine RJ, Weller RN, Kimbrough WF, Pashley DH. Effect of root resection on the apical sealing ability of mineral trioxide aggregate. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2003;95(6):732–5.
Khayat B, Michonneau JC. Tissue conservation in endodontic microsurgery. J Odontol Stomatol. 2008;37:275–86.
Reit C, Hirsch J. Surgical endodontic retreatment. Int Endod J. 1986;19(3):107–12.
Chong BS, Pitt Ford TR, Hudson MB. A prospective clinical study of mineral trioxide aggregate and IRM when used as root-end filling materials in endodontic surgery. Int Endod J. 2003;36(8):520–6.
Rud J, Rud V, Munksgaard EC. Long-term evaluation of retrograde root filling with dentin-bonded resin composite. J Endod. 1996;22(2):90–3.
von Arx T, Jensen SS, Hanni S, Friedman S. Five-year longitudinal assessment of the prognosis of apical microsurgery. J Endod. 2012;38(5):570–9.
Walivaara DA, Abrahamsson P, Samfors KA, Isaksson S. Periapical surgery using ultrasonic preparation and thermoplasticized gutta-percha with AH Plus sealer or IRM as retrograde root-end fillings in 160 consecutive teeth: a prospective randomized clinical study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009;108(5):784–9.
Gutmann JL. Surgical endodontics: past, present, and future. Endod Top. 2014;30:29–43.
Baek SH, Plenk H Jr, Kim S. Periapical tissue responses and cementum regeneration with amalgam, SuperEBA, and MTA as root-end filling materials. J Endod. 2005;31(6):444–9.
Fernandez-Yanez Sanchez A, Leco-Berrocal MI, Martinez-Gonzalez JM. Metaanalysis of filler materials in periapical surgery. Med Oral Patol Oral Cir Bucal. 2008;13(3):E180–5.
Lindeboom JA, Frenken JW, Kroon FH, van den Akker HP. A comparative prospective randomized clinical study of MTA and IRM as root-end filling materials in single-rooted teeth in endodontic surgery. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2005;100(4):495–500.
Valois CR, Costa ED Jr. Influence of the thickness of mineral trioxide aggregate on sealing ability of root-end fillings in vitro. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2004;97(1):108–11.
Garcia B, Penarrocha M, Marti E, Gay-Escodad C, von Arx T. Pain and swelling after periapical surgery related to oral hygiene and smoking. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2007;104(2):271–6.
Garcia B, Larrazabal C, Penarrocha M, Penarrocha M. Pain and swelling in periapical surgery. A literature update. Med Oral Patol Oral Cir Bucal. 2008;13(11):E726–9.
Cruse PJ, Foord R. The epidemiology of wound infection. A 10-year prospective study of 62,939 wounds. Surg Clin North Am. 1980;60(1):27–40.
Kruse C, Spin-Neto R, Christiansen R, Wenzel A, Kirkevang LL. Periapical bone healing after apicectomy with and without retrograde root filling with mineral trioxide aggregate: a 6-year follow-up of a randomized controlled trial. J Endod. 2016;42(4):533–7.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2018 Springer International Publishing AG
About this chapter
Cite this chapter
Jonasson, P., Ragnarsson, M.F. (2018). Surgical Retreatment. In: Kvist, T. (eds) Apical Periodontitis in Root-Filled Teeth. Springer, Cham. https://doi.org/10.1007/978-3-319-57250-5_7
Download citation
DOI: https://doi.org/10.1007/978-3-319-57250-5_7
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-57248-2
Online ISBN: 978-3-319-57250-5
eBook Packages: MedicineMedicine (R0)