l5 tic surgery
TRANSCRIPT
Ronald C. Taylor DDS, MSDBCDS Dental School University of Maryland
CASE SELECTION ILLUMINATION AND MAGNIFICATION OSTEOTOMY SIZE RESECTED ROOT SURFACE BEVEL ANGLE ISTHMUS IDENTIFICATION AND PREPARATION RETROPREPARATION HEMOSTASIS RETROGRADE FILLING
Unsuccessful non-surgical endodontic treatment
Retreatment not possible/practical, or unsuccessful
Perforation repair Anatomically approachable Medical condition acceptable
MANIDBULAR CANAL MENTAL FORAMEN SINUS FRENULUM
1st 2nd 3rd
SCHNEIDERIAN MEMEBRANE Maxillary 2nd Molars Are
Closest to the Sinus 5% of Maxillary Root Apicies
Protrude into the Sinus Torabinejad OOO 1992
Sinus Perforations Occur in 28% of Maxillary Posterior Endodontic Surgeries. Bernhart DCNA 1997
Practical Lessons in Endo Surgery, 1998
Ochsenbein-Luebke (Submarginal)
Intrasulcular
Full Thickness Mucoperiosteal Flap
Split Thickness Flap
Flaps Can Be Buccal or Palatal
Ochsenbein-Luebke Intrasulcular flap
Practical Lessons in Endo Surgery, 1998
Practical Lessons in Endo Surgery, 1998
Practical Lessons in Endo Surgery, 1998
Practical Lessons in Endo Surgery, 1998
Practical Lessons in Endo Surgery, 1998
Practical Lessons in Endo Surgery, 1998
ADEQUATE REMOVAL OF BONE ESTIMATE THE ROOT LENGTH TAKE A RADIOGRAPH WITH AN
RADIOOPQUE INDICATOR
Osteotomy
Practical Lessons in Endo Surgery, 1998
Practical Lessons in Endo Surgery, 1998
Practical Lessons in Endo Surgery, 1998
LOCATING FORAMEN IDENTIFICATION OF ROOT END COMPLETE RESECTION OF ROOT END IDENTIFICATION OF ROOT CANALS BEVELING ISTHMUS
Practical Lessons in Endo Surgery, 1998
Practical Lessons in Endo Surgery, 1998
The incidence of an isthmus is highest in the apical 3-5mm level.
Not treating the isthmus can lead to failure. Kim JOE 1995 Gomes IEJ 2003
Less apical leakage with a 0 bevel.
The depth of the retrograde filling should be at least 3mm. Gilheany, Figdor &
Tiaz JOE 1994
Surgical Ultrasonic Tips (Wuchenich, Meadows and Torabinejad; JOE ‘93)
More effective than round burs Root end preparations were
Deeper Cleaner More Parallel
Practical Lessons in Endo Surgery, 1998
Practical Lessons in Endo Surgery, 1998
Practical Lessons in Endo Surgery, 1998
Practical Lessons in Endo Surgery, 1998
Practical Lessons in Endo Surgery, 1998
Practical Lessons in Endo Surgery, 1998
Practical Lessons in Endo Surgery, 1998
Dentsply
Dentsply
Dentsply
Pre-OpPost-Op Recall (1 yr)
Pre-Op Post-Op Recall (1 yr)
Practical Lessons in Endo Surgery, 1998
Interrupted Continuous Mattress Continuous Blanket Continuous Sling
OBJECTIVE = PRIMARY CLOSURE
Resorbable Gut Chromic Gut Vicryl
Non-resorbable Silk Nylon
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