Apicoectomy Tutorial – When, Why and How – PDP148

You’re faced with a beautiful crown with what seems like a decent root filling – but there’s an apical infection present. Is the answer always endodontic re-treatment? When should we instead consider apical surgery so we can clear the infection WITHOUT drilling through the crown or having to dismantle posts?In this episode, specialist endodontist Dr. Peter Raftery and his associate Dr. Manpreet Dhesi will be talking about the Apicoectomy procedure that can be used to treat root-filled teeth using a ‘retrograde’ approach. They will discuss about how it fits into general dentistry, its indications and contraindications, its cost analysis vs implants and and the entire protocol for performing Apicoectomy https://youtu.be/sZOsLuuf-Vo Watch PDP148 on YoutubeProtrusive Dental Pearl: The periradicular surgery guidelines issued by BES and the Royal College of Surgeons. Download the guidelines about periradicular surgery or on the app under the Protrusive Vault (where all the different files and infographics and the different things that you get as a Protrusive premium member)BES-RCS-Peri-Radicular-Surgery-GuidelinesDownloadDownload Protrusive App on iOS and Android and Claim your Verifiable CPD/CE by answering a few questions + You can get EARLY ACCESS to the episode + EXCLUSIVE contentHighlights of this episode:1:37 The Protrusive Dental Pearl 3:32 Dr. Peter Raftery’s introduction4:05 Dr. Manpreet Dhesi’s introduction5:16 What is Apicoectomy?6:29 Oral Surgeons vs Endodontists?8:48 Is a Microscope mandatory for Apicoectomy?10:08 Apicoectomy for posteriors11:00 Isolation Protocol for Anterior Apicoectomies11:35 Apicoectomy Protocol15:03 Disinfection Protocol18:41 Moisture control from the bleeding20:43 Risk of surgical emphysema – Is special handpiece needed?21:52 Indications and Contraindications for Apicoectomy 27:46 Endodontic Re-treatment29:05 Cost benefit analysis of Apicoectomy31:20 Success rate for Apicoectomy34:19 Case Scenario 1: 82-year old patient with a singular crown, root filling and a radicular pathology42:10 Retrograde fillings of choice  44:09 Grafting after Apicoectomy – is it needed?45:04 Equipments for Apicoectomy47:11 Learning more about ApicoectomyApical Microsurgery Instrument Kit- the mirror, the pluggers, and the little curettes by Hu-Friedy UKApical-Microsurgery-Instrument-KitDownloadIf you enjoyed this episode, check this another episode by Dr. Peter Raftery: How to Save ‘Hopeless’ Teeth with the Surgical Extrusion Technique