Endoscopically Assisted Apicoectomy at Tooth 26

Procedure

• Anatomic principles of the apicoectomy
• Indications and contraindications for the apicoectomy
• Endoscopically assisted apicoectomy procedure in practice
• Criteria for assessment of treatment outcome
• Advantages of using an optical visualization system

Contents
Objective: The objective of this video is to demonstrate the procedure for an apicoectomy and to show the advantages of endoscopic guidance.

Introduction: The anatomic principles of the maxillary and mandibular dentition will be described in relation to the adjacent structures. The pathophysiology of the development of periapical ostitis and the physiology of wound healing will also be explained. The final segment provides a summary of the indications and contraindications for the apicoectomy as a method of conservative dentistry.

Case presentation: Short patient history and presentation of radiological and clinical findings. Demonstration of the surgical procedure: Incision technique, osteotomy, exposure of root tips, apical resection, visualization and planing of the root surfaces, sinuscopy, rinsing of maxillary sinus, closure of defect, mucosal suture.

Conclusions: The current findings on the endoscopically assisted apicoectomy indicate that:

• the Success Rate is over 90 %,
• Outcome Assessments must be obtained clinically and radiographically,
• Digital Subtraction Radiography can demonstrate signs of Osseous Wound Healing for Radiological Confirmation of Reossification,
• Clinical failures can also be associated with Shrinkage of the Translucent Zone in Radiographic Images,
• Radiographic Assessments must be made in conjunction with Clinical Findings in order to provide a reliable prediction of the Treatment Outcome.