Microcirurgia endodôntica
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A endodontia cirúrgica é muitas vezes um último recurso quando o retratamento não cirúrgico é impraticável ou pouco suscetível de melhorar um resultado anterior. Em particular, apenas a intervenção cirúrgica pode resolver casos que envolvam uma lesão persistente relacionada com um quisto periapical ou com uma anatomia complexa do canal. Nos últimos anos, foram introduzidas técnicas modernas que incluem a utilização de ferramentas de ampliação, micro-instrumentos, instrumentos ultra-sónicos e materiais de preenchimento mais biocompatíveis. As técnicas actuais de EMS implicam a utilização de um microscópio operatório para identificar melhor os canais, as fracturas e os istmos; instrumentos ultra-sónicos de preparação angulada da extremidade radicular que facilitam uma preparação precisa da extremidade radicular ao longo do eixo do canal radicular sem bloquear a visibilidade; e novos materiais de obturação da extremidade radicular, como o agregado de trióxido mineral (MTA), que melhoraram a resistência à fuga, a biocompatibilidade, as propriedades antimicrobianas e a tolerância à humidade . O sucesso de cura da técnica ultra-sónica de 95% foi comparado com 65% de sucesso com as técnicas tradicionais.
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