Secrets of a Successful Endodontic Microsurgery
Endodontic failures are mainly caused by the persistence of microorganisms within the root canal system. Non-surgical retreatment is often the best therapeutic solution. Nonetheless, sometimes peri-radicular pathology does not heal after (re)treatment; or an orthograde retreatment presents a poor benefit-risk ratio due to the presence of a post whose removal could lead to tooth fracture; or a retreatment would fail to manage an iatrogenic situation with a lesion accompanied by a large extrusion of filling material. With the appropriate armamentarium, such as microscope and ultrasonic tips, Endodontic microsurgery performed with atraumatic tissue management, preparation and retro-filling of the canals gives excellent results with a healing rate exceeding 90%.
This communication, mainly based on recent bibliography and clinical studies, describes the different steps of endodontic microsurgery treatments where the dental surgeon needs to make choices for incision, depth preparation and filling materials and justifies the most appropriate choices according to various clinical situations.
Dr. Diemer earned his dental surgery’s doctorate in 1995 at the University of Toulouse. He also has a Master in Science and Medical Biology (1998), a postgraduate diploma in pedagogy
(2001), and a PhD from the Paul Sabatier University (2006). He is full professor in the Toulouse Dental Surgery’s University, at the head of Endodontic and conservative dentistry department.
He is directing the postgraduate program of endodontics and of hypnosis and co-directing the postgraduate program of Dental Medicine and Sport. He is member of the French National College of Teachers in Dentistry (CNEOC) and of the French Society of Endodontics (SFE). He is member of the scientific board of Toulouse Dental Surgery’s University and of the international relations office. Dr. Diemer has full hospital practice and is attached to the laboratory: Clement Ader Institute (Surface, Machining, Materials and Tools team –
UMR CNRS 5312). He has presented numerous lectures and continuing education, and published many national and international articles.