Thursday, July 21, 2011

Success with endodontic surgery (apicoectomy)

This patient was kicked in the face by a horse in 1998. Teeth were displaced (luxated). She repositioned them herself. RCT's on #24 and #25 were done in 2008 by her general dentist. In
Jan 2011 she is having pain, percussion sensitivity, normal probings, adjacent teeth WNL. These teeth are diagnosed as: Prior RCT's w/ Symptomatic Apical Periodontitis.

Axial and sagittal views in CBCT verify that these are single canals incisors. It also shows us the extent of the bone loss prior to our surgical access.

Due to the large size of the canals and over extension of the previous RCT, it was recommended to treat these teeth surgically with an apicoectomy.

Apicoectomy completed with MTA retrofill.

At 6 month recall the teeth are fully functional and asymptomatic. Radiographs show impressive healing of the apical bone. Endodontic surgery can preserve the natural tooth, which then helps to preserve the periodontium.

UPDATE: 1 year recall. Pt asymptomatic, fully functional.


The following case is a similar, double apicoectomy. The CBCT confirmed that there were no missed canals. The large posts and good crown margins were the reasons we chose surgery over non-surgical retreatment.

Endodontic surgery saves natural teeth.


Navydent said...

good post...keep posting.

Dr Richard Casson Dentist said...

Nice site, blog and post. We also have an informative dental blog on our site, enjoy :-)

Justin M. Parente, DMD said...

Nice cases, those are some crisp CBCT images.

Advanced Endodontic Care said...


What amazing cases to choose from. It's always amazing to think about how much apicoectomy procedures and endodontic care change people's lives. Especially after being kicked in the face by a horse!

Great write up.

all on 4 said...

This is really a very good post and the CBCT images are really very clear. Please keep sharing.

Dental Implants Cost said...

Good informative article and the CBCT pictures are very perfect where the surgical areas are shown clearly.

cosmetic surgery perth said...

Amazing and clear step-by-step pictures. I still can't get over the part where it took a whole year to fully recover.