Speakers - 2026

Title: Efficacy of apical microsurgery in persistent and recurrent apical lesions of anterior and posterior teeth. Reports of 30 cases in the medium and long term

Abstract

Globally, dental caries has been identified as the most prevalent disease in permanent teeth. Periodontal diseases have also been a major contributing factor to this global prevalence. Pulp and apical diseases are now also considered highly recurrent in permanent teeth. Recent systematic reviews of meta-analyses from numerous studies revealed that 39% of teeth have undergone root canal treatment. These findings support the understanding that half of the world's adult population has at least one tooth with root canal treatment. Furthermore, the lack of timely treatment of dental caries leads to pulpitis and its progression to apical lesions. Apical lesions require root canal treatment if the tooth has not already undergone root canal treatment, or retreatment or surgical access if the tooth has undergone root canal treatment. The cases followed in this case report consisted of an adult population with teeth that had undergone successful endodontic treatment but presented with recurrent, unresolved apical lesions where endodontic retreatment was not possible due to the lack of coronal access. Apical microsurgery was performed with magnification and micro-access using manual and piezoelectric microsurgical instrumentation in anterior and posterior teeth. Retrograde obturation was used in all cases, and bone graft material was used in cases of significant lesion size. Clinical and radiographic follow-up was performed every 6 months for up to 5 years. The success rate of apical microsurgery was approximately 92% at both 2 and 5 years in the reported case series. Success was defined by the following criteria: clinical signs of apical health, radiographic signs of apical healing, absence of pain, and normal tooth function.