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Abstract
There is an immense difference between tradizional Endodontic Surgery and Micro-Endo Surgery.
Microsurgical techniques made possible and accessible results,that were unimaginable before.Under microscopic control,the
operative techniques reached continous changes,allowing a better precision and quality standards.
The dramatic evolution from Endo Surgery to Micro-Endo Surgery has enlarged the horizon of therapeutic options.
Illumination and magnification through the Microscope has fundamentally and radically changed the way endo surgery can
be performed.
Keywords: Operatory Microscope, Light and illumination, GTR, Fresh socket implants, maxillary sinus
INTRODUCTION
Operatory Microscope has generally brought a new
dimension in Dentistry and particularly in Endodontic
Surgery [Figure 1a].
Light and magnification have determined a new higher
standard of quality in the profession.[1]
Microscopy is a young specialty in a great and continuous
evolution, not only in the field of application, but also in
the development of new instruments and techniques.
Dentistry rests its quality standard on the realization of the
higher possible precision.
Concepts based on evolution, advanced technology
applications, characteristics of perfectioned materials have
brought major improvment on long-term results and an
excellent predictability in the surgical techniques.
In particular, the extensive use of the Microscope in
conventional endo has enlarged the indications for the
positive treatment of failures and restricted the indications
for surgical treatment.
The concept of apical surgery has been expanded to
periradicular surgery and today we speak in terms of
Micro-Endo Surgery.[2]
Address for correspondence:
DOI:
10.4103/0972-0707.148864
Pecora and Pecora: A new dimension in endo surgery: Micro endo surgery
Pecora and Pecora: A new dimension in endo surgery: Micro endo surgery
Figure 2: (a) Failure of endo-treatment (b) Apicoectomy without retrofilling (c) Recurrency at 3 years
(d) Retrofilling 22X (e) Rx post-op control (f) Healing at 6 months
Pecora and Pecora: A new dimension in endo surgery: Micro endo surgery
Figure 3: (a) Cutting surface evaluation, methylene blue 2% staining (b) Retro-filling control 22X
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Pecora and Pecora: A new dimension in endo surgery: Micro endo surgery
Figure 4: (a) Lesion above the apex TYPE I (b) Middle root lesion TYPE II (c) Endo-marginal lesion
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Pecora and Pecora: A new dimension in endo surgery: Micro endo surgery
Figure 5: (a) Large lesion with endo-perio communication (b) Apicoectomy with calcium sulfate graft (c) Rx at 2
months (d) Rx at 6 months
We have to add:
control of infections progression and bone destruction.
Implants as alternative
Once the decision to extract the tooth is made, clinicians
have to face two therapeutic options:
Immediate post-extraction regeneration
Fresh socket implant with immediate loading.
There are no objective criteria of evaluation, but only
clinical experience and studies focusing single aspects of
the problem exists.
The decision can be the most favorable compromise when
we combine experience of the operator, logical approach
and a few fundamental points [Figures 6a and b].
Quality of bone and primary stability are the main factors.
Primary stability depends on bone density and implants
design. Bone density depends on bone trabeculae and their
structure.
It is essential for the surgeon to decide how and where
to place the implant and whether an implant can be
immediately loaded.
The leading concept is the evaluation of the post-extractive
defect:
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Pecora and Pecora: A new dimension in endo surgery: Micro endo surgery
CONCLUSIONS
The dramatic evolution from Endo-Surgery to Micro-Endo
Surgery has enlarged the horizon of therapeutic options.
Illumination and magnification through the Microscope
have fundamentally and radically changed the way
endodontic surgery can be performed.
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Pecora and Pecora: A new dimension in endo surgery: Micro endo surgery
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How to cite this article: Pecora GE, Pecora CN. A new dimension
in endo surgery: Micro endo surgery. J Conserv Dent 2015;18:7-14.
Source of Support: Nil, Conflict of Interest: None declared.
Announcement
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