IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-ISSN: 2279-0853, p-ISSN: 2279-0861.Volume 20, Issue 1 Ser.9 (January. 2021), PP 42-45 www.iosrjournals.org DOI: 10.9790/0853-2001094245 www.iosrjournal.org 42 | Page Surgical Endodontic Management of Non Healing Periapical Lesion – Case Report Dr.Chandrakant Velip 1 , Dr. Manoj Agarawal 2 , Dr. Deepak Goel 3 , Dr. Kamal Kishore Binawara 4 1 MDS: Department of Conservative Dentistry and Endodontics, RUHS College of Dental Sciences, Jaipur, Rajasthan 2 Associate professor : Department of Conservative Dentistry and Endodontics, RUHS College of Dental Sciences, Jaipur, Rajasthan 3 Assistant professor : Department of Conservative Dentistry and Endodontics, RUHS College of Dental Sciences, Jaipur, Rajasthan 4 SeniorDemonstrator : Department of Conservative Dentistry and Endodontics, RUHS College of Dental Sciences, Jaipur, Rajasthan Abstract AIM- Regeneration of soft and hard tissue following removal of periapical lesion and sealing of apical third of root dentin. METHODS AND MATERIALS- One of the most common pathological condition affecting periradicular tissues is periapical lesions which can be radicular cysts, dental granulomas or abscess. Conventional endodontic treatment aims to eradicate bacteria from root canal system and establish effective barrier against root recontamination. When conventional endodontic therapy does not give favourable outcome endodontic surgery is recommended in periapical diseases treatment. Apicoectomy includes curettage of periapical lesion followed by root end resection and retrograde filling using a biocompatible material. CONCLUSION- Surgical endodontic treatment is an adjunct to conventional endodontics which is an invasive procedure, reducing the time period needed for healing of periapical lesions. Key Words- Apicoectomy, Root resection, Retrograde filling, Periapical lesion --------------------------------------------------------------------------------------------------------------------------------------- Date of Submission: 03-01-2021 Date of Acceptance: 16-01-2021 --------------------------------------------------------------------------------------------------------------------------------------- I. Introduction One of the most common pathological condition affecting periradicular tissues is periapical lesions 1 . Invasion of microbes and their subsequent infection of root canal system play a decisive role in the initiation and progression of periapical lesions 2 . Periapical lesions can be radicular cysts, dental granulomas or abscess. The incidence of cyst is 6%- 55% among all periapical lesions, granulomas occur from 9% -87% and abscess from 28%-70% 3 . Conventional endodontic treatment aims to eradicate bacteria from root canal system and establish effective barrier against root recontamination 4 . To achieve success- cleaning, shaping and filling of the entire root canal system are essential steps in endodontic therapy. Causes of failure of conventional root canal therapy is related to persistent infection (presence of residual bacteria) and secondary infection (reinfection in a previously disinfected canal) 5 . Endodontic surgery is recommended in periapical diseases treatment, when conventional endodontic therapy does not give favourable outcome. Indications for periapical surgery are- 1. Radiological findings of apical periodontitis and/or symptoms associated with an obstructed canal (the obstruction proved not to be removable, displacement did not seem feasible or the risk of damage was too great), 2. Extruded material with clinical or radiological findings of apical periodontitis and/or symptoms continuing over a prolonged period, 3. Persisting or emerging disease following root-canal treatment when root canal retreatment is inappropriate, and 4. Perforation of the root or the floor of the pulp chamber and where it is impossible to treat from within the pulp cavity