Indications for surgical endodontics (apicoectomy and retrograde filling) include: tooth with an open apex and concomitant periapical infection not responding to standard endodontic therapy; apical perforations leading to clinical or radiographic failure; fragmented endodontic files in a location that prevents complete preparation and filling of the canals and subsequently leads to clinical or radiographic failure; standard endodontic therapy failure; coronal approach not possible (narrow canal, aberrant canal formation, pulp stones, canal calcification); and, horizontal fracture of the root apex. The objective of this procedure is to resect the apex and seal the root canal at the newly created apex using a retrograde filling technique. A clinical case and cadaver specimen are used to describe surgical endodontics of the maxillary canine tooth step-by-step.
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