Endodontic surgery. Part 1: an overview

Endodontic surgery encompasses a broad range of surgical techniques that are aimed at addressing both pulpal and peri-radicular disease. Surgical root canal re-treatment (SRCReT) or root-end surgery is the most extensively researched endodontic surgical technique, and is aimed at treating root canals with persistent apical periodontitis when conventional non-surgical root canal re-treatment (NSRCReT) has failed, or when it is impractical to perform.¹ However, surgical techniques that aim to manage endodontic emergencies, facilitate assessment or diagnosis and procedures to correct root or tooth defects are also included within this field (Table 1). Part 1 of this two-part series aims to give a broad overview of the applications of endodontic surgery. Part 2 provides a more in-depth review of the surgical protocol required for root-end surgery.

Endodontic infections may result in apical abscess formation and the accumulation of both pus and inflammatory exudate within the peri-radicular tissues.² The effective drainage of pus is one of the cornerstones of management of acute dental infections. Drainage through the root canal alone cannot always be achieved or may be ineffective because of the limited degree to which it can occur. Exudate will flow more freely from a patent unfilled canal compared to a canal that has been previously root canal treated. Therefore, incision and drainage may be required to remove trapped exudate.³