Cirurgia parendodôntica: relato de caso

Abstract

The failure of endodontic treatment can be confirmed through clinical and radiographic examinations, with the appearance of spontaneous pain, pain on palpation, vertical percussion, edema and the presence of periapical lesions. Given these signs and symptoms, endodontic retreatment is the first choice and when this is not possible, endodontic surgery is indicated. The main indications for surgery are: difficulty in accessing the root canal through the coronary approach, with the presence of a full metal-ceramic crown and intracanal pin, or calcified root canals with periapical lesions, fractured instruments, deviations, apical perforations and steps. Several techniques are described in the literature, including periapical curettage, apicoectomy, surgery with simultaneous retrograde filling, retro instrumentation with retro-filling are the most used. The objective of this work is to present a case report of a 25-year-old patient who sought out Universidade Brasil after the emergence of intraoral edema. The patient had previous root canal treatment and developed an acute periapical abscess after undergoing internal bleaching. In the 1st session, intraoral drainage and coronary opening were performed with the placement of intracanal medication Formocresol for 48 hours. In the 2nd session, during the removal of the filling material, she found a perforation in the middle third of the root. The filling material was removed to the location of the deviation, and Calcium Hydroxide medication was placed for 20 days. In the 3rd session, the canal was filled with Bio-C Repair (Angelus) and an apicoectomy of the apical third and curettage of the endodontic lesion were performed. The patient did not present pain on apical palpation, vertical percussion, spontaneous pain or edema in the postoperative period and in the 15-day follow-up. The patient will continue to be monitored for evaluation of the repair in the periapical region. When traditional methods of endodontic treatment are not viable, or when there are accidents during the intervention, endodontic surgery is an excellent alternative for maintaining the dental element, promoting health and restoring aesthetics and function to the patient.