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References

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Endodontic surgery. Part 1: an overview

From Volume 49, Issue 10, November 2022 | Pages 819-828

Authors

Nicholas Jackson

BChD, MSc, MJDF RCS Eng, RAF

Specialty Registrar in Restorative Dentistry, Defence Primary Healthcare (Dental), Defence Centre for Rehabilitative Dentistry

Articles by Nicholas Jackson

Graeme Bryce

BDS, MSc, MEndoRCS, MRD RCPSG, FDS (Rest Dent), FDTFEd,

BDS, MSc, MEndoRCS, MRD FDS (Rest), FDTFEd, Specialist in Endodontics, Consultant in Restorative Dentistry, Defence Primary Healthcare (Dental), Defence Centre for Rehabilitative Dentistry, Aldershot

Articles by Graeme Bryce

Email Graeme Bryce

Geoffrey St George

BDS, DGDP (UK), MSc, FDS RCS, FDS (Rest Dent)

Consultant in Restorative Dentistry

Articles by Geoffrey St George

Poonam Kalsi

BDS (Hons), MSc, MJDF RCS, FDS (Rest Dent)

Consultant in Restorative Dentistry, Guy's and St Thomas' NHS Foundation Trust, London

Articles by Poonam Kalsi

Abstract

Surgical root canal re-treatment (SRCReT) or root-end surgery is the surgical endodontic technique most commonly studied and undertaken in clinical practice. A range of diagnostic, emergency and corrective surgical procedures may be included under the umbrella of endodontic surgery. The first article in this two-part series uses the best available evidence and clinical examples to provide the clinician with an overview of endodontic surgery.

CPD/Clinical Relevance: An updated review of endodontic surgical techniques is of relevance to clinicians.

Article

Endodontic surgery encompasses a broad range of surgical techniques that are aimed at addressing both pulpal and peri-radicular disease. Surgical root canal re-treatment (SRCReT) or root-end surgery is the most extensively researched endodontic surgical technique, and is aimed at treating root canals with persistent apical periodontitis when conventional non-surgical root canal re-treatment (NSRCReT) has failed, or when it is impractical to perform.1 However, surgical techniques that aim to manage endodontic emergencies, facilitate assessment or diagnosis and procedures to correct root or tooth defects are also included within this field (Table 1). Part 1 of this two-part series aims to give a broad overview of the applications of endodontic surgery. Part 2 provides a more in-depth review of the surgical protocol required for root-end surgery.

Endodontic infections may result in apical abscess formation and the accumulation of both pus and inflammatory exudate within the peri-radicular tissues.2 The effective drainage of pus is one of the cornerstones of management of acute dental infections. Drainage through the root canal alone cannot always be achieved or may be ineffective because of the limited degree to which it can occur. Exudate will flow more freely from a patent unfilled canal compared to a canal that has been previously root canal treated. Therefore, incision and drainage may be required to remove trapped exudate.3

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