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Endodontic Surgery

  • As in all endodontic surgery procedures, the objective of periapical surgery is to ensure the placements of proper seal between the periodontium and the root canal foramina.
  • When this seal cannot be achieved satisfactorily by working  through the canal system (orthograde filling), a surgical procedure permits visual and manipulative control of the area and placement of the seal through the surgical site.
  • Local considerations:
  • ocalized acute inflammation: where as emergency procedure such as incision and derange or trephination may be indicated, elective periapical surgery should be avoided.
  • Anatomic considerations: procedures that penetrate the mandibular canal, maxillary sinus, mental foramen,  floor of the nares, or that serves the grater  palatine blood vessels should be avoided when ever possible.

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