Endodontic surgery in the anterior maxilla

Introduction/Objectives: The present case report the importance of endodontic surgery in the treatment of two radicular lesions that were associated to endodontically compromised teeth as well as the multidisciplinary value in order to get better aesthetic and functional results. Case Description: A healthy 46-year female patient presented to the FMDUP dental clinic in November 2015 with complaint of an aesthetically unpleasing on her upper anterior teeth. The clinical examination revealed that the central and lateral incisors were endodontically treated and had aesthetically inadequate restorations. Radiographically two osteolytic lesions were visualized in anterior maxilla. Endodontic surgery was the first choice of treatment for excision of the lesions and control of the bone defect. A later rehabilitation of upper anterior teeth using fixed prosthesis was suggested. Discussion: Although the prognosis of endodontic microsurgery in young patients is better we take measures to perform the conventional surgery within the main parameters for its success: good curettage of the bone wall and irrigation with saline solution, apical section of the incisors and apical obturation with 3 mm depth with MTA biomaterial because of its biocompatibility, osteogenic potential and excellent sealing in the elimination of untreated apical ducts. Conclusion: Properly performed endodontic surgery is an effective surgical method when root canal treatment fails. Follow-up is essential to detect early recurrences as well as the multidisciplinary work in order to correct other outcomes that may be inherent to perioendodontic problems. Keywords: apicoectomy, endodontic surgery, anterior maxilla, radicular cyst, MTA, outcomes