In current endodontic practice, introduction of operating microscope, ultrasonic instruments, and microinstruments has induced a big change in the field of surgical retreatment. In this study, we aimed to offer key steps of endodontic microsurgery procedure compared with traditional root-end surgery, and to evaluate factors influencing success and failure based on published articles.
Endodontic microsurgery is a surgical procedure performed with the aid of a microscope, ultrasonic instruments and modern microsurgical instruments. The microscope provides magnification and illumination - essential for identifying minute details of the apical anatomy. Ultrasonic instruments facilitate the precise root-end preparation that is within the anatomical space of the canal. Modern endodontics can therefore be performed with precision and predictability, thus eliminating the disadvantages inherent in traditional periapical surgery such as large osteotomy, beveled apicoectomy, inaccurate root-end preparation and the inability to observe isthmus.
Factors influencing the outcomes of endodontic microsurgery may be diverse, but standardization of procedures can minimize its range. Among patient and tooth-related factors, periodontal status and tooth position are known to be prognostic, but there are only few articles concerning this matter. High-evidence randomized clinical trials or prospective cohort studies are needed to confirm these findings.
It is common for clinicians to encounter endodontically treated teeth that contain posts within their roots. If endodontic treatment is failed, these posts must be removed to facilitate successful nonsurgical retreatment.
There have been many techniques such as ultrasonic instrument, Ruddle post removal system, Eggler post remover and Masserann kit developed to facilitate removal of posts from the root canal space. But these methods may be disadvantageous because long length of time required for post removal and fracture of post or teeth. In now days new post removal technique using ATD automatic bridge remover was introduced. Advantages of this method are simple and short time consuming compare to others.
This article served as a successful case report of post removal using ATD automatic bridge remover.