Abstract
Surgical endodontic treatment has been chosen for failed endodontic (re-)treatment. The main cause of root canal treatment failure is presence of bacteria in the root canal. Surgical intervention like apicoectomy is valuable to resolve a persistent apical lesion caused by the formation of biofilms in root canal microstructures such as additional canals, isthmus, fins, cracks, fractures, perforations, and so on.
It has reported that modern techniques as endodontic microsurgery for apicoectomy, using dental surgical microscope is superior in achieving higher success rates for root-end surgery when compared with traditional techniques. The use of a surgical microscope, ultrasonic preparation, and newly developed restorative materials in apical surgery allows for inspection of the surgical field at high magnification with high power illumination, to detect of microstructures, to distinguish between bone and root, and to identify adjacent important anatomical structures. In addition, it makes possible precise root end resection with minimal or no bevel and accurate preparation of the root end cavity to the depth of 3 mm allows minimal bone removal. Moreover, preoperative diagnosis using cone-beam computed tomography is valuable for accurate diagnosis and surgical treatment.
By introducing an endodontic microsurgery, apicoectomy represents a potential minimally invasive endodontic method. This review will focus on the basic concepts, techniques, instruments/equipment, and materials of endodontic microsurgery for apicoectomy.
https://ror.org/03bwzch55 
