Apicectomy is a surgical removal of the apical portion of the tooth. To achieve this, access to the root apex is gained via a mucoperiosteal flap and then the bone is removed around the apex.
WHAT ARE THE AIM AND OBJECTIVE OF APECICTOMY?
To eradicate persistent infection in the periapical tissues.
To eliminate the apical delta of minor root canals that cannot be effectively sealed by conventional endodontics i.e.root canal treatment.
To excise a root apex that cannot be sealed successfully due to anatomical anomalies such as marked curvature.
Indications of endodontic surgery:
Failed conventional endodontics
Conventional endodontics is impracticable
Due to calcified root canal.
Marked curvature of the root..
Incomplete apical development.
Inability to disinfect the canal
Inability to control persistent inflammatory changes in the periodontal tissues.
Root resorption.
Persistent pathological changes at the apex of a tooth
Surgically accessible perforation of the root.
Fractured reamer or file that cannot be retrieved by non surgical endodontists.
Horizontal fracture of the apical third of the root.
Contraindications.
Proximity of the periapical tissues to the maxillary antrum or mental foramen may
necessitate removal of the tooth.
Some medical conditions may contraindicate oral surgery.
Anatomical structures may compromise flap design, e.g. short sulcus.
Co- existing periodontal disease such as horizontal, vertical bone loss.
