ENDODONTIC SURGERY: A REVIEW OF POSTOPERATIVE AND HEALING OUTCOME

The purpose of this review was to give the reader an update about the postoperative period and healing outcome after surgical endodontic retreatment. Endodontic surgery has become a standard of care for dental maintenance if conventional endodontic retreatment is not able to eliminate the infection, it is important to know how to manage the post-surgical care, due it might directly interfere in the healing outcome after the surgical procedure. An electronic search of the relevant English-language literature was conducted in the MEDLINE/ PubMed database using the following key-words combinations: Postoperative care; apical surgery; apicoectomy; wound healing. Articles from 1980 to 2011 were included. Based on the results of this present review, the postoperative period after the surgery treatment is very mild, without any complications, being similar to any dental surgical discomfort, as swelling, bleeding and pain, which could be easily controlled with simple medicine. Regarding the repair after endodontic surgery, the length of follow-up time and the healing evaluation criteria affect the outcome, and 1-year follow-up periods might be insufficient to predict a long-term healing.

Classification and types of flaps in endodontic surgery

The success of endodontic surgeries can be significantly associated with the selected dental flap. Many flaps have been reported among studies in the literature with variable frequencies of advantages and disadvantages and with different indications for each flap. This literature review discusses the most commonly reported types of endodontics flaps along with the reported advantages and disadvantages, in addition to the uses, applications, and most probable indications and contraindications for each designed flap. Among the reported flap designs, clinical success and favorable outcomes were observed with the ones that limited the damage to the root-attached tissues. Moreover, crestal bone loss has been reported to be minimal when using the full mucoperiosteal flap designs. Many previous studies have reported that using triangular and rectangular flap designs has been associated with favorable events regarding crestal bone loss, with the observed complete healing of the resorption damaging events and absent alternations of the heights of the crestal bone that were potentially affected. Further details of each flap design are provided within the full manuscript of this article based on the obtained evidence from previous investigations.

Endodontic Microsurgical Instruments - A Review

Indications for endodontic surgery include failed nonsurgical treatment or retreatment, anatomical problems or iatrogenic errors. Endodontic surgery was considered as the last option with instruments that were unsuitable, surgical sites with inadequate vision and increased incidence of post-operative complication. But today endodontic surgery has evolved into endodontic microsurgery with the advancement in illumination, magnification, instruments and materials. Higher magnification and micro-instruments have increased the clinical outcome of endodontic surgery. Traditional instruments used in endodontic surgery are too large for the small osteotomy sites of microsurgery. Few of the instruments used for microsurgery are the smaller version of the traditional instruments. Endodontic microsurgery represents a minimally invasive treatment option with predictable outcome with the use of micro-instruments. A high success rate of nearly 93.5 % is reported, thus, making microsurgery a predictable option for the management of periapical pathology where surgical root treatment is not possible. The advanced techniques developed to overcome the barriers seen in traditional endodontic surgery have allowed the clinicians to achieve higher success rates. Along with the micro-instruments, the introduction of biomimetic materials has also led to the favourable results after endodontic surgery. This article discusses the different microsurgical instruments available for microsurgical procedures. KEY WORDS Curette, Microblade, Microsurgery, Piezotomes, Retractor, Ultrasonic.

PERSISTENT APICAL PERIODONTITIS AFTER ENDODONTIC TREATMENT: SURGICAL MANAGEMENT

The high success of endodontic therapy for apical periodontitis treatment is well known. However, studies showed that between 20% to 60% of treated teeth in the population present with apical periodontitis after root canal therapy. When viable, non-surgical retreatment is the rst option while endodontic surgery should be the last resource for elimination of the disease. The aim of this case report is emphasize the potentiality of the successful outcome of surgical endodontic treatment following failed non-surgical treatment of a second maxillary premolar and rst maxillary molar

Endodontic Surgery: A Review of Postoperative and Healing Outcome

The purpose of this review was to give the reader an update about the postoperative period and healing outcome after surgical endodontic retreatment. Endodontic surgery has become a standard of care for dental maintenance if conventional endodontic retreatment is not able to eliminate the infection, it is important to know how to manage the post-surgical care; due it might directly interfere in the healing outcome after the surgical procedure. Based on the results of the present review, the postoperative period after the surgery treatment is very mild, without any complications, being similar to any dental surgical discomfort, as swelling, bleeding and pain, which could be easily controlled with simple medicine. Regarding the repair after endodontic surgery, the length of follow-up time and the healing evaluation criteria affect the outcome, and 1-year follow-up periods might be insufficient to predict a long-term healing.

THE MAGICAL INSTRUMENT WHICH CAN POSTPONE ENDODONTIC SURGERY

The ultimate target of any endodontic treatment with periapical lesion is to induce complete bony healing of the lesion in which faster healing comprises with apical surgery but patient always wants an alternative of the surgery and this is the magical instrument which can postpone the endodontic surgery-The Apexum Device

Impact of Zr-Doped Bi2O3 Radiopacifier by Spray Pyrolysis on Mineral Trioxide Aggregate

Mineral trioxide aggregates (MTA) have been developed as a dental root repair material for a range of endodontics procedures. They contain a small amount of bismuth oxide (Bi2O3) as a radiopacifier to differentiate adjacent bone tissue on radiographs for endodontic surgery. However, the addition of Bi2O3 to MTA will increase porosity and lead to the deterioration of MTA’s mechanical properties. Besides, Bi2O3 can also increase the setting time of MTA. To improve upon the undesirable effects caused by Bi2O3 additives, we used zirconium ions (Zr) to substitute the bismuth ions (Bi) in the Bi2O3 compound. Here we demonstrate a new composition of Zr-doped Bi2O3 using spray pyrolysis, a technique for producing fine solid particles. The results showed that Zr ions were doped into the Bi2O3 compound, resulting in the phase of Bi7.38Zr0.62O12.31. The results of materials analysis showed Bi2O3 with 15 mol % of Zr doping increased its radiopacity (5.16 ± 0.2 mm Al) and mechanical strength, compared to Bi2O3 and other ratios of Zr-doped Bi2O3. To our knowledge, this is the first study of fabrication and analysis of Zr-doped Bi2O3 radiopacifiers through the spray pyrolysis procedure. The study reveals that spray pyrolysis can be a new technique for preparing Zr-doped Bi2O3 radiopacifiers for future dental applications.