Myths about Periradicular surgery

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Myths about Periradicular surgery
Prepared by Dr Sanjay Chauhan
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What is Periradicular Surgery ?
SYNONYMS
..Periradicular surgery
..Periapical Surgery
..Endodontic Microsurgery
..Apicoectomy
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Question Arises ?

• Is Periradicular surgery really required in all
  cases undergoing endodontic treatment ?

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Definite Answer is ..

• No
• Not at all..

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• There was a time, not so long back when all root
  canal treatments in teeth with any periapical
  radioluncency were accompanied by some sort of
  Periradicular surgical procedure.

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• This was a MYTH.

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• What has been the usual line of treatment when we
  see any periapical radioluncency ..

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(No Transcript)
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• What is exactly needed is the better
  understanding of the basic principles of
  endodontics and following them properly in
  practice.

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• With this enhanced knowledge, it is clear that
  most of the cases would succeed without any kind
  of surgical intervention.

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• Hence the list of indications for surgery has
  been considerably reduced over the years.

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Myths of Periradicular surgery

• 1.Periapical radioluncency extending more than
  1/3rd of the root.
• 2.Presence of a cyst.
• 3.Blunderbuss.
• 4.Persistent continuous pain or draining sinus
  following R.C.T.( Failed Treatment )
• 5.External / Internal root resorption.
• 6.Severe Apical curvature.
• 7.Over extended sealer.

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Bone regeneration Following R.C.T. without any
surgical intervention.

• Diagnostic Radiograph

• Sumitra
• 46/F
• Rewari

Periapical Radioluncency

• D/D
• .Periapical cyst
• Periapical granuloma
• Periapical abscess

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• Working length radiograph

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• Fitting of Master GP Cone

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• Post obturation Radiograph

Bone Regeneration begins
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• Radiograph 30 Days after
• Obturation

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• 60 Days after obturation

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Various Stages of Treatment
Before treatment
30 Days after obturation
60 Days after obturation
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Bone Regeneration following R.C.T. Without any
surgical intervention

• Diagnostic Radiograph

• Anita
• 24/F
• Rewari

• Periapical Radioluncency

D/D

• Periapical cyst
• Periapical Granuloma
• Periapical Abscess

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• Working length Radiograph

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• Fitting Of Master GP Cone

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• Post obturation Radiograph

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• Radiograph 30 Days after obturation

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• Radiograph 90days after obturation

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Various stages of Treatment
Before Treatment
30 Days After Obturation
90 Days After obturation
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Treatment of Blunderbuss with CUSTOMIZED CONE
TECHNIQUE

• Diagnostic Radiograph

Blunderbuss With Periapical Radioluncency

• Bhavesh
• 24/M
• Alwar

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• Working Length Radiograph

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• Fitting Of Master GP Cone

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• Obturation done with CUSTOMIZED CONE TECHNIQUE.

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• Radiograph taken 90 days after obturation

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Comparison
Before Treatment
90After Treatment
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A Case Of Retreatment( Pt complains of continuous
pain following endodontic therapy )

• Diagnostic Radiograph

• Reena
• 24/F
• Rewari

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• Working Length radiograph After removal of GP

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• Fitting Of Master GP Cone

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• Post Obturation Radiograph

Accessory Canal Filled
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Comparisons
Before Treatment
After Treatment
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Treatment Of Internal Resorption

• Diagnostic Radiograph

• Renu
• 34/M
• Rewari

Internal Resorption
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• Working Length Radiograph

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• Fitting Of Master GP Cone

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• Post Obturation Radiograph

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Bone regeneration and Resorption of excessive
sealer

• Diagnostic Radiograph

Komal 24/F Rewari
1st TM Of Pregnancy
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• Emergency RC Opening done to relieve pain , but
  pain was not relieved

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• Apical Patency done to relieve pain

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• Fitting of Master GP Cone

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• Post Obturation Radiograph

Sealer Extruded Beyond Apex
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Bone Regeneration starts and excessive sealer
being resorbed

• Radiograph 90 days after obturation

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Comparison
Before treatment
At the time of obturation
90 days after obturation
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