Apicectomy and simultaneous obturation of root canals: a clinical case report

Submitted: 29 July 2021
Accepted: 18 November 2021
Published: 16 February 2022
Abstract Views: 1658
PDF: 781
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

Authors

Aim: This case report presents a maxillary lateral incisor that had already being treated by endodontic therapy and apicectomy surgery, but still had a persistent lesion. To maintain the tooth in the oral cavity, a third intervention was necessary in which parendodontic surgery followed by retro-obturation was performed. The aim of this report is to demonstrate the effectiveness of the treatment by means of clinical and radiographic follow-ups (6 and 12 months).

Summary: Considering the patient's complaint and the clinical and radiographic aspects, it was decided to perform the parendodontic surgery. The surgery procedures were osteotomy, curettage, apicectomy, root canal retreatment and retrofilling with Mineral Trioxide Aggregate, graft with lyophilized bone and, finally, use of collagen membrane. Through clinical and radiographic examinations were possible to observe that there was good healing of the soft and hard tissues, suggesting total regression of the lesion, and absence of signs and symptoms. Even if periapical lesions persist for a long time after interventions, the association of multiple procedures should be considered to enable the maintenance of the tooth in the oral cavity.

Key learning points

  • The parendodontic surgery associating osteotomy, curettage, apicectomy, root canal retreatment and retrofilling can be effective to treat persistent periapical lesion.
  • The use of graft with lyophilized bone and collagen membrane helps in bone repair.

Dimensions

Altmetric

PlumX Metrics

Downloads

Download data is not yet available.

Citations

1. Shetty A, Wali A, Hegde MN, et al. Autogenous chin graft in treatment of periapical lesion: a case report. Sch J Med Case Rep. 2014;2:772-775.
2. Kinjrawi L, Abdallah A. Efficacy of non-surgical retreatment with and without using ultrasonics and dental microscope. Int J Dent Health Sci. 2016;3:3-14.
3. Locurcio LL, Leeson R. A case of periradicular surgery: apicoectomy and obturation of the apex, a bold act. Stomatological Dis Sci. 2017; 1:76-80.
4. Souza POC, Oliveira CFP, Mamede Neto I, et al. Apical surgery: therapeutic option for endodontic failure. J Health Sci. 2018;3:185-189.
5. Del Fabbro M, Corbella S, Sequeira-Byron P, et al. Endodontic procedures for retreatment of periapical lesions. Cochrane Database Syst Rev. 2016; 10:1-108.
6. Prati C, Azizi A, Pirani C, et al. Apical surgery vs apical surgery with simultaneous orthograde retreatment: a prospective cohort clinical study of teeth affected by persistent periapical lesion. Giornal Italiano Endod. 2018;32:2-8.
7. Tsesis I, Rosen E, Tamse A, et al. Effect of Guided Tissue Regeneration on the Outcome of Surgical Endodontic Treatment: A Systematic Review and Meta-analysis. Journal of Endodontics. 2011;37:1039–1045.
8. Bashutski, JD, Wang HL. Periodontal and Endodontic Regeneration. Journal of Endodontics. 2009;35:321–328.
9. von Arx T. Apical surgery: a review of current techniques and outcome. Saudi Dent J. 2011;23:9-15.
10. Bernabe PF, Holland R, Morandi R, et al. Comparative study of MTA and other materials in retrofilling of pulpless dogs’ teeth. Braz Dent J 2005;16:149-55.
11. Pompa DG. Guided tissue repair of complete buccal dehiscences associated with periapical defects: a clinical retrospective study. J Am Dent Assoc 1997;128:989-97
12. Ghorbanzadeh S, Ashraf H, Hosseinpour S, et al. Nonsurgical management of a large periapical lesion: a case report. Iranian Endod J. 2017;12:253-256.
13. Ayna B, Ayna E, Çelenk S. Endodontic and prosthetic treatment of teeth with periapical lesions in a 16-year-old-girl. J Appl Oral Sci. 2010;18:201-206.
14. Fehlberg BK, Bittencourt G. Parendodontic surgery - apicoectomy and simultaneous obturation of root canals with mineral trioxide aggregate (MTA): case report. Dental Press Endod. 2019;9:48-57.
15. Garlapati R, Venigalla BS, Patil JD, et al. Surgincal management of mandibular central incisors with dumbbell shaped periapical lesion: a case report. Case Rep Dent. 2014;2014:769381:1-5.
16. Holland R, Gomes JEF, Cintra LTA, et al. Factors affecting the periapical healing process of endodontically treated teeth. J. Appl. Oral Sci. 2017;25:465-476.
17. Kinjrawi L, Abdallah A. Efficacy of non-surgical retreatment with and without using ultrasonics and dental microscope. Int J Dent Health Sci. 2016;3:3-14.
18. Von Arx T. Mineral Trioxide Aggregate (MTA) – a success story in apical surgery. Swiss Dent J. 2016;126(6):573-595.
19. Sanchez-Torres A, Sanchez-Garces M, Gay-Escoda C. Materials and prognostic factors of bone regeneration in periapical surgery: A systematic review. Medicina Oral Patología Oral y Cirugia Bucal. 2014;19:e419–e425.

Supporting Agencies

None

How to Cite

Samapio de Castro, H., Nunes Cabral, R., Kerhwald, R., Salmeron, S., Casaroto, A. R., & Mazucatto Queiroz, P. (2022). Apicectomy and simultaneous obturation of root canals: a clinical case report. Giornale Italiano Di Endodonzia, 36(1). https://doi.org/10.32067/GIE.2021.35.02.46