Endodontic periradicular microsurgery is a dental procedure to treat apical periodontitis in cases in which healing has not occurred after non-surgical treatment or if it is not feasible. Recent advances in techniques and materials have resulted in more predictable outcomes. Piezotome is a new and innovative device, but limited evidence is available regarding its use in endodontics. The aim of this study is to assess the healing pattern of conventional periradicular microsurgery and piezoelectric periradicular microsurgery in 2- Dimensional and 3-Dimensional imaging, and further to perform histological analysis for the presence, location, and arrangement of bacteria in the excised apical portion of the root canal system.
Medically fit patients
Age (18-65 )
Teeth that are periodontally healthy
Coronally sealed root canal treated teeth
Patients with an active systematic disease that may affect the short- and long-term outcomes or restrict surgical intervention
Emotionally distressed patients
Patients who had received analgesics or antibiotics prior to surgery will be postponed
Cases where orthograde endodontic treatment is feasible, will be retreated at the post-graduate clinics and not included in this study
Parallel
Piezo endodontic surgery
Procedure/SurgeryOsteotomy will be done with Piezosurgery touch. After the soft tissue curettage and uncovering the root apex, the last 3 mm of the root apex will be resected perpendicular to the long axis of the tooth using piezotome. apical preparation will be performed and Biodentine®retrograde filling material will be placed. The flap will be re-approximated and interrupted suture using non-absorbable monofilament suture will be applied. Finally, Post-operative parallel Digital view.
Conventional endodontic surgery
Procedure/SurgeryAfter the soft tissue curettage and exposure of the root apex, the osteotomy will be performed using a conventional surgical handpiece. The same steps will be followed to prepare and restore the root, as well as to reposition the flap.
Radiographic Healing
To compare conventional and piezotome endodontic apical surgery in terms of healing using 2-Dimensional and 3-Dimensional imaging CBCT.
Histological outcome
To correlate histological findings with clinical observation and radiographic findings for failed root canal treated teeth presenting
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King Abdullah University Hospital
Lead sponsor
Jordan University of Science and Technology
Collaborator
