peri radicular surgery Flashcards

1
Q

aims of PR surgery

A
  1. achieve apical seal
  2. remove existing infection i.e. excision of apex / curettage
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2
Q

indications for PRS

A

failure of endo
1. obstruction - calcification / broken instrument / root dilaceration / root #
2. root filler error or problem - under or over filled / open apex
3. other - lateral root canals, poor host tissue response, poor natural drainage of infection
4. pathology - cyst
5. post crown teeth - endo shortcomings / problem with post
6. lateral perforation

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3
Q

causes of failure of PRS

A
  1. inadequate seal - extra / bifid root, too little apex removed, seal of incorrect shape, lateral perforation problem, displacement of seal, lateral canals
  2. inadequate support - too much apex removed, poor perio status, excessive occlusal loading, apical 1/3 #
  3. other - longitudinal root split, poor healing response, exposure of root apex
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4
Q

options for retrograde root filling

A
  1. amalgam - disadv = amalgam tattoo
  2. ZOE - calzinol; works well & cheap
  3. MTA - very good but very expensive
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5
Q

process

A

access flap
remove bone
remove 3mm apex
remove 3mm of GP inside tooth
retrograde root sealer
close flap
note - apicectomy is part of peri radicular surgery process

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