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At least 73 records · Page 4Linked to original sources
PubMed2000

Microsurgical instruments for root-end cavity preparation following apicoectomy: a literature review.

Root-end cavities have traditionally been prepared by means of small round or inverted cone burs in a micro-handpiece. Since sonically or ultrasonically driven microsurgical retrotips became commercially available in the early 1990s, this new technique of retrograde root canal instrumentation has been established as an essential adjunct in periradicular surgery. At first glance, the most relevant clinical advantages are the enhanced access to root ends in limited working space and the smaller osteotomy required for surgical access because of the various angled designs and small size of the retrotips. However, a number of experimental studies comparing root-end preparations made with microsurgical tips to those made with burs have demonstrated other advantages of this new technique, such as deeper cavities that follow the original path of the root canal more closely. The more centered root-end preparation also lessens the risk of lateral perforation. In addition, the geometry of the retrotip design does not require a beveled root-end resection for surgical access thus decreasing the number of exposed dentinal tubules. A controversial issue of sonic or ultrasonic root-end preparation is the formation of cracks or microfractures, and its implication on healing success. The present paper reviews experimental and clinical studies about the use of microsurgical retrotips in periradicular surgery and discusses many issues raised in previous papers.

Apicoectomy↗
PubMed1978

Scanning electron microscopic examination of root after apicoectomy.

The scanning electron microscope was used to examine resected areas of eight roots of human teeth extracted after long intervals following surgical procedures. Some resorption lacunae were observed in the areas with protuberances of newly formed cementum. In the lacunae, honeycomb-like structures were found. On the resected surface, residues of ligaments and periodontal fibers, and in one of the specimens dentinal tubules with odontoblastic processes protruding above the surface were present.

Apicoectomy↗
PubMed2002

SEM observations of resected root canal ends following apicoectomy.

The purpose of this study was to examine the apical foramen of root apices extracted during apicotomies. A total of 25 teeth extracted from 25 patients admitted to the Department of Conservative Dentistry at Tokyo Dental College's Chiba Hospital were used for the study. All patients were between 22 to 56 years of age at the time of the study, and each of the 25 cases was determined clinically on radiographs to be chronic apical suppurative periodontitis. Microsurgery was performed on all cases, and the extracted root apices were then observed using SEM. The results demonstrated a wide opening, greater than 350 microns as measured along the major axis, of the apical foramen in 80% of the cases. Various characteristics indicative of resorption were observed around the apical foramen. These features included those believed to have been caused by overinstrumentation during root canal treatment as well as irregularly shaped areas presumed to be apical lesions that had enlarged and eroded. We observed a high frequency of manifestations of cementum resorption surrounding the root apices of teeth with apical lesions. Furthermore, we concluded that in the majority of cases in the present study, due to the fact that the apical foramen exceeded normal opening dimensions as a result of overinstrumentation during root canal treatment or resorption around the root apex, prolongation of the lesions had occurred in response to direct contact of microbial infectious matter and tissues surrounding the root apex over a large area. The above finding suggested that, in cases in which the apical foramen is destroyed through overinstrumentation larger than #35 or in which the apical foramen opens up to dimensions greater than 350 microns due to pathologic resorption, surgical intervention may be indicated. On the other hand, in 64% of the cases, an accessory canal was observed in the root apical lesion. Based on this observation, the presence of an accessory canal in the root apex may contribute to some degree to the prolongation of the lesion.

Adult↗
PubMed1975

[Apicoectomy and focal diseases].

The so-called focal infections are today considered to be polyetiologic manifestations, in which there is a summation of various aggressions. Bacterial products, toxic or antigenic substances originating from different foci are but one of the elements susceptible of unleashing the disease. This explains why there are so many foci and so few results after their elimination. Scientific evidence shows that the histologic result of an apicectomy is considerably worse than the radiological evidence might lead to believe. Inflammation may persist for years before it disappears. Radiographs are therefore only a coarse criterion for judging results of healing. When facing a disease caused by focal infection, the possible foci should be eliminated quickly and as radically as possible.

Apicoectomy↗