Use of Apicectomy in the Treatment of Refractory Injury

Endodontic treatments provide high success rates, due to technical, scientific and biological evolution. However, periapical lesions that do not regress after endodontic treatment, which forms exudate, can be considered a persistent disease and very complex clinical measures must be taken to resolve it. Therefore, with the failure of endodontic therapy, an excellent tool can be used to solve this problem, which is the use of parendodontic surgery. Among the procedures used in this surgery, there is apicectomy, which consists of removing the apical portion of the dental element followed of curettage of pathological tissue. Thus, this study aimed to assess apicectomy by means of follow-up exams, such as digital and computerized radiography and tomography, in recurrent periapical disease after failure of endodontic treatment in a case study. The clinical case had a retrograde filling with the addition of mineral trioxide. In this work, the relevance of parendodontic surgery was verified in the case which the good quality conventional endodontic treatment cannot promote the repair. It can be seen that imaging resources, such as Cone-Beam Computed Tomography, allowed an image with greater quality and effectiveness because of its three-dimensional character, resulting in better evidence of bone repair and demonstrating the success of parendodontic surgical treatment.