Open Surgical Retreatment and Apicoectomy
Keywords:
APICECTOMÍA; ENDODONCIA; RETRATAMIENTO., APICOECTOMY; ENDODONTICS; RETREATMENT., APICECTOMÍA; ENDODONTIA; RETRATAMENTO.Abstract
Introduction: apicoectomy is the surgical procedure of choice when conventional endodontic treatment fails and is considered the last resort to preserve the affected tooth. It involves resection of 2–3 mm of the apical root segment, retrograde cavity preparation, sealing with biocompatible materials, and debridement of surrounding periapical tissues.
Objective: to present a case managed with open surgical retreatment and apicoectomy due to persistent pain and paresthesia associated with a strip perforation (false canal).
Case Presentation: a 15-year-old White female patient presented with pain and paresthesia in an upper anterior tooth previously treated with root canal therapy. Occlusal radiography revealed an unobturated main canal and a false canal, indicating endodontic failure. Open surgical retreatment and apicoectomy were performed using silver amalgam for retrograde filling. Clinical and radiographic follow-up over 18 months confirmed complete periapical healing and absence of symptoms.
Conclusion: apicoectomy of a root compromised by a false canal represents a viable therapeutic alternative when non-surgical retreatment is not feasible. It enables preservation of the dental organ and its aesthetic, phonetic, and masticatory functions, while also supporting the patient’s psychological well-being—particularly crucial in adolescent care.
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