What is an apicoectomy?

Apicoectomy is the surgical removal of tissue from the tooth root tip, when a root canal is no longer working. Typically there is an infection at the root tip.

What techniques and products are best for endodontic microsurgery (apicoectomy)? – MTA Super EBA

Can use EndoSequence Root Repair Material Putty for apico.

BP-RPM is comparable to MTA for endodontic microsurgery according to Zhoe JOE 2017

There is no difference in success with MTA or Super EBA at 4 years 182 teeth RCT based on Kim JOE 2016  In this study they determine success by following healing using peri-apical x-rays from three angles.

Super EBA = MTA   260 RC study

ProRoot MTA beats SuperEBA May 12  170 RCT

Hemostatic agents epi and AlCl were comparable in terms of impact they have on healing of apicoectomy. Peñarrocha-Diago JOE 2018

What are the success rates for apical surgery?

10 year success rate was 80% for Arx JOE 2019

Apicoectomy has better outcomes than retreatment. This makes sense for many reasons and I agree UNLESS we can see a reason for failure. Typically a reason for failure can be something like the original doctor not treating the MB2 canal. Curtis JOE 2018

Endodontic microsurgery: When to give up on a tooth and do the dental implant

Dental implant is a superior option to endodontic microsurgery with respect to survival. Literature does not allow comparison of other relevant outcomes such as psycho-social, economic, and need for additional interventions. Systemic Review Torabinejad Jan 2015 JOE

Endodontic microsurgery (apicoectomy) survival rates are reported around 96% at 2-4 years and 88% at 4-6 years.

Studies on endodontic surgical treatment

Additional reading for microsurgical endodontics.

Microsurgical endodontics by Khayat is a new textbook that has a nice review from JOE in 2019.

Apicoectomy steps and instrumentation

• Use the esthetic buccal flap