Theoretical approach of apicectomy as a modern surgical procedure – a literature review

Liappis Εvangelos, Mikrogeorgis Georgios
 
Liappis Εvangelos1, Mikrogeorgis Georgios2
1Undergraduate Student
2Associate Professor, Department of Endodontology, Section of Pathology and Therapeutics of Dental Tissues
School of Dentistry, Aristotle University of Thessaloniki

Hellenic Archives of Oral & Maxillofacial Surgery (2022) 2, 111-125

DOI https://dx.doi.org/10.54936/haoms232111125

Introduction: Apicectomy is one of periapical surgical techniques, which is nowadays applied in everyday clinical practice. As a surgical method, it has been steadily improved with successive modifications, whose initiation is dated back to the 19th century. Since the first attempt to apply this specific interventional technique, particularly during the 1850s, until today, it has gradually intrigued dentists’ interest, for the purpose of offering more efficient overall dental care to endodontic patients.
Objective: This research aims to present the scientifically documented indications, contraindications and clinical results of apicectomy from an endodontic perspective.
Materials-Methods: The electronic databases PubMed and Google Scholar were used for the accumulation of all relevant to apicectomy papers. Apart from this, useful information was found in scientific textbooks, which deal with this specific periradicular surgery.
Results: Throughout the evaluation of the literature, it was found out that apicectomy is a valuable surgical technique, mainly indicated for endodontically treated teeth with periapical lesions or iatrogenic incidents. Moreover, dentists conduct apicectomy on clinical cases, where histopathological investigation of the inflamed periradicular tissues is needed. This surgical method is also applied on teeth which require endodontic treatment, but present with special developmental abnormalities, for instance extremely curved roots. Last but not least, one should not ignore endodontic cases of patients with complicated and challenging dental anatomical features. Nevertheless, there are systemic diseases and dental factors, such as periodontal pathology, that prevent dentists from executing apicectomies. At the same time, various special anatomical difficulties, the personality of the patients and the lack of surgical experience of the dental hygienist act as prohibiting factors as sell. The literature indicates that apicectomy is a highly, not only short-term but also long-term, successful periapical surgical technique, whose clinical success is measured through scientifically established clinical and radiographic criteria.
Conclusions: In conclusion, it is obvious that apicectomy can guarantee the functional and biological restoration of endodontically impacted teeth with periradicular lesions, under specific circumstances, especially when these teeth cannot be treated conservatively. As a result, this surgical method decisively contributes to the increase of the percentage of natural teeth remaining at the natural dentitions of general population. In this way, apicectomy has settled a limitation at unnecessary extractions of teeth, thus improving the life quality of the patients.



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