Periradicular Surgey the Conservative Approach - Case Report

The main objective of apical surgery is to create an optimal environment for periradicular tissue healing. the most common type of periradicular surgery is apicoectomy associated with root-end filling, in which a portion of the apical root third is removed (3 4 mm), and a cavity with the characteristics of Blacks Class I cavity design (1) is prepared (retropreparation) and filled (retrofilling). The placement of bone graft and use of a membrane technique in guided tissue regeneration (GTR) is widely applied in surgical dentistry. The GTR principle involves the use of a physiologic barrier over the bone defect to preclude the oral epithelium or gingival connective tissue from growing into the bone space so that cells with osteogenic potential can repopulate the defective area. Many approaches to root-end preparation have been advocated, with variations based on access, root anatomy, armamentarium, and surgeon expertise and philosophy. Recent studies have reported favorable outcome for treatment of periapical defects using GTR. All these factors highlight a positive prognosis for the tooth after periradicular surgery, which is now considered a valid treatment to keep the tooth as a functional unit in the oral cavity.