Marsupialização e apicectomia em incisivos superiores: relato de caso

Abstract

Endodontic surgery in apicectomy mode is the last therapeutic option for dental maintenance and over the last few years, it has presented a significant technological advance, mainly with the implementation of ultrasonic inserts, the surgical microscope and bioceramic cements. Thus, this study aims to present a clinical case of failure in endodontic treatment, with indication of endodontic surgery, in the category of apicoectomy with retrograde obturation, for the maintenance of the dental element in the oral cavity. After performing the clinical and imaging examination (periapical radiography and cone beam tomography), an extensive periradicular lesion was observed involving the upper right central incisor, with initial indication to the patient to decompress the lesion through marsupialization. After a period of 4 months, a marked reduction in the size of the lesion was observed, at which time, endodontic surgery was indicated in the form of apicectomy, with the use of microscopy, ultrasonic inserts and bioceramic cement. It is concluded that the surgical modality of apicectomy with retrograde obturation is a safe and effective alternative for the permanence of the dental element in the oral cavity, provided that its indication is correct, well designed and planned.