Apicoectomy Case Studies

Case Study #1

A 46 year-old patient presented with a recurrent abscess and localized swelling on the buccal aspect of Tooth #20. The patient had a history of conventional endodontic therapy and retreatment therapy (twice) performed elsewhere. The periodontal condition for the tooth was less than ideal, but the patient had limited funds and wished to save her tooth and bridge. An apicoectomy was performed and the healing was uneventful. She presented for a follow-up visit three years following the surgery. Upon follow-up, she was asymptomatic and showed radiographic evidence of complete osseous healing.

Pre-operative film 1/4/07	Post-operative film 1/4/07	Follow-up film 4/9/10

Retrofill material: MTA (mineral trioxide aggregate)
Biopsy result: Periapical granuloma

Case Study #2

A 15 year-old patient presented with a large localized swelling in the buccal aspect of Tooth #9. She had a history of root canal therapy many years prior, following a traumatic injury. The radiograph shows evidence of an open apex and a poorly-condensed gross overfill of the gutta percha material. An apicoectomy was performed and the healing was uneventful. Upon follow-up, she is asymptomatic and shows radiographic evidence of nearly complete osseous healing in only 10 months following the surgery.

Pre-operative film 2/8/10	Post-operative film 2/8/10	Follow-up film 12/9/10

Retrofill material: MTA (mineral trioxide aggregate)
Biopsy result: Periapical cyst