Complications and failures in apicoectomy — an evaluation of 3281 cases

Complications and failures in apicoectomy — an evaluation of 3281 cases

Abstracts showed soft tissue formation around the hydroxyl apatite grafts. New bone formation in the form of network bone was not directly induced, bu...

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Abstracts showed soft tissue formation around the hydroxyl apatite grafts. New bone formation in the form of network bone was not directly induced, but was a secondary phenomenon similar to the healing of a bone fracture.

APICOECTOMY Statistical survey on 9446 apicoectomies. U. Bumberger-NieBIbeck, V. Kunde and B. Hoffmeister, Kiel.

In a joint retrospective study, 9446 apicoectomies performed in the Oral Surgery Departments in Mainz and Kiel during 1974 to 1985 had been evaluated by means of clinical, radiological and histological findings. Age- and sex-related differences could not be found. Most apicoectomies had been performed on the upper incisors: 73.3% (Mainz) and 61.1% (Kiel). Teeth 11 and 21 had been treated most commonly (16%).

Statistical evaluation of 9000 apicoectomies. Technical changes in intraoperative root filling. S. Becket, P. Tetsch, R. Karcher and S. Trippler, Mainz

The apicoectomies performed at the dental clinics of Mainz and Kiel between 1975 and 1985 were evaluated according to the type of root filling technique used.

Complications and failures in apicoectomy - an evaluation of 3281 cases. St. Kopp, B. Hoffmeister and U. Bumberget, Kiel

Complications and failures in apicoectomy are frequently due to the indication and surgical technique. 3281 apicoectomies performed between 1974 and 1985 were catamnestically evaluated. Intraoperative complications occurred in 5.8% of the cases, wound healing disorders in 12%. Complications are even more frequent in high-risk patients, above all in diabetics. Apart from the looseness of the teeth and the location of the line of incision, the extent of the resection and the suture technique applied are also of importance for the complications.

Endodontic complications as indication for apicoectomy. F. Barsekow and R. Schmelzeisen, Hannover

Apart from the classical indication for apicoectomy, with the objective of removing the apex along with its accessory canals and the affected periapical tissue, a secondary apicoectomy may be necessary after complications during the endodontic treatment. This situation most commonly arises when root filling material has been excessively compressed and forced into the periapical area. Depending on the chemical composition as well as on the amount and localization of the overcompressed material the severity of the damage is variable. It is particularly severe when filling material has been forced into the alveolar canal, since this almost invariably results in a permanent lesion of the nerve. Easy to correct are problems, such as a via falsa near the apex or broken root canal instruments in the vincinity of the apex.

Inferior alveolar nerve and root amputation. R. Schmelzle and G. Gehrke, TObingen.

During root amputation procedures in the mandibular buccal area, the risk of damaging the inferior alveolar nerve is particularly high when it passes in close topographic relation with the apex. It is seldom the often-blamed nerve block that causes a nerve lesion, but the rotary instruments that sever and destroy the nerve. The mental nerve is particularly endangered during amputations in the mandibular premolar region. Microsurgical treatment options include neurolysis, nerve sutures and nerve grafting. With the cause of the lesion known, the surgical treatment should be instituted immediately; with the cause unknown, the treatment should start within the 2nd 3 months following the lesion. Thanks to the modern possibilities of microsurgery, the prognosis of such nerve lesions can be assessed more favorably.

Intraoperative preparation of the root canal using ultrasound. Experimental results and clinical experience. H. H. Lindorf, R. MEfller and S. Berger, NOrnberg

It was the objective of this study to find

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out to what extent the use of instruments vibrating with ultrasonic frequencies for root canal preparation might be superior to conventional preparation techniques in surgical endodontics. A bacteriologic examination revealed that a reduction in the number of organisms in the root canal may be achieved using ultrasound, and this effect is further enhanced by the simultaneous application of disinfectants. In a clinical study on the intraoperative application of ultrasound during apicoectomies of 103 teeth with 220 root canals, the success rate did not differ from that of a control group in which conventional root preparation techniques were used. Although the preparation of complex root canals was facilitated in a certain way, additional mechanical preparation could not be eliminated in any of the cases.

Intraoperative localization of the apex in apicoectomy with the aid of endodonUc cold light. R. Siegert and 7-. Liepe, Hamburg

An intraradicular flexible glass fiber cable illuminates the periapical bone for the intraoperative localization of the tooth root prior to an orthograde resection. This new technique as well as various types of glass fiber cables were studied on a mounted cow's mandible; the possible clinical applications are described.

A comparison of the results of preoperative and intraoperative root filling with apicoectomy. U. Lindemann, St. Kopp and B. Hoffmeister, Kiel

1070 apicoectomies with preoperative and t508 with intraoperative root fillings performed between 1974 and 1985, were catamnestically compared with each other according to age, indication, localization, incidence and filling material used. Patients were randomly chosen from both groups (60 and 132, respectively) and re-evaluated. With a failure rate of 18.8%, apicoectomy combined with intraoperative root filling is superior to preoperative root filling with 34.6% failures.

Prospective study comparing preoperative and intraoperative root fill-