[Apicoectomy: indications and surgical technique].
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The term of apicectomy has been well-known for more than 200 years, nevertheless it is not performed frequently on molars. As a result of this a lot of molars became extracted. The aim of the authors was to present the new surgical technique which is described in detail. The radicular cyst localised on the palatal root of the first maxillary molar was operated on. Uneventful healing was obtained. This surgical technique is recommended in some special cases.
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The present in vitro study investigated the sealing of retrograde fillings compounded of two different cements in consideration of cracking after root-end preparation of resected dental roots using diamond-coated ultrasonic retrotips. Root-end cavities were prepared in 32 resected roots using diamond-coated ultrasonic retrotips. The samples were divided into two groups. The first group was filled using zinc-oxide cement (Super-EBA-Cement), the second with mineral-trioxide-aggregate (Pro Root MTA). After resection, root-end preparation and retrograde filling, the samples were analysed using macro-zoom photography and scanning electron microscopy. The sealing quality of the filling materials was detected through dye penetration test. The average degree of penetration of the samples filled with Super-EBA-Cement was 2.19 and of the samples filled with Pro Root MTA 0.44 respectively. Accordingly the sealing of Pro Root MTA in vitro is superior to the sealing of Super-EBA-Cement. Retrograde conditioning of resected roots with ultrasonic retrotips represents an efficient and sparing alternative to conventional root-end preparation techniques.
In a post-treatment study 50 apicoectomized teeth in 34 patients being treated with apical titanium cones between 1988 and 1990 were registered. After a mean postoperative observation period of 15.3 months, 42 teeth were still in situ and subjected to clinical and radiographical evaluations. Their mobility was measured by the periotest method. A resulting 84% success rate demonstrates the technique to be suitable to safeguard a prolonged lifetime of severe damaged teeth by use of conical pins which guarantee a perfect closing at neoapex.