Treatment by Par endodontic surgery of per apical injury involving three previous dental elements: Case report

Endodontic practice is indicated as intervention for diagnosed teeth with pulp involvement, such as necrosis and irreversible pulpitis. The success of treatment is related to the professional's technical ability, to the understanding of pathological idiosyncrasies and elaboration of strategies covering diagnosis, treatment and prognosis to solve the case within each particularity, besides of the patient's biological principles and pulp and periradicular condition. It is undeniable that technological advances in endodontics, such as rotary, microscope and ultrasound contributed in an indispensable way to the increase of the success rates of the endodontic treatments, however the failure portion triggers the need for other procedures, such as retreatment and paraendodontic surgery. In this sense, paraendodontic surgery presents itself as an intervention for elements in which the root canal filling did not obtain a satisfactory result, being justified curettage of the lesion and removal of the apex of the dental element. Accordingly, The present study aimed to report the case of a patient who, in a routine consultation, presented in the radiographic examination a radiolucent area extended by elements 11, 21 and 22, 21 being endodontically treated three years ago. For the best visualization, diagnosis and planning, computed tomography was chosen to subsequent paraendodontic surgery. Follow-up of the case completed one year and four months with evidence of success, ensuring the efficiency of the surgery paraendodontic as an option to prevent dental organ extraction and rehabilitation through implants or prosthesis.