Supporting patient-centred care with endodontic microsurgery

The use of magnification has become integral to endodontic success. Utilisation of the technology has led to an increase in the deployment of microsurgery techniques, where practitioners perform endodontic procedures with an operating microscope. The clinical approach affords several advantages. However, it is advanced in nature and often only within the remit of appropriately trained endodontic specialists.

The benefits of endodontic microsurgery

Endodontic microsurgery is often the last resort when previous treatment has not provided a solution to the patient’s problem. As such, it is an advanced branch of dentistry that requires dedicated training and skill.

With this, treatment is predictable and often successful. Magnification improves visualisation of the treatment site and allows identification of root apices and anatomical details such as microfractures, canal fins, and lateral canals. This contributes to a high success rate in endodontic microsurgery – with the literature suggesting this to be in the range of 78-91%. Additionally, the predictability of the treatment modality, combined with the use of modern biocompatible and bioactive root-end filling materials, delivers a survival rate of 79 – 100% for treated teeth after up to 13 years post-operatively. Some research even points to a higher success rate for microsurgery than contemporary root-end surgery. This elevates the potential of high-power magnification to support exceptional patient-centred care.

There are also positive implications for the patient journey when microsurgical techniques are selected. The very nature of microsurgery promotes a minimally invasive treatment approach, reducing recovery time for individuals. To support this, studies show that patients are less likely to experience extensive post-operative swelling after endodontic microsurgery.

Overcoming complications

These success rates depend on sophisticated techniques and technologies. As is true of any advanced clinical procedure, endodontic microsurgery is not without its challenges. Two of the main reasons for failure of primary surgery are a lack of root-end filling and missed canals, emphasising the need for advanced technologies and clinical experience.

To achieve the best results, there is broad evidence of the need for sound diagnosis, appropriate case selection, and meticulous surgical technique. It is also important for the operating clinician to understand the type of endodontic lesion they are treating, as well as the associated prognosis.

Thorough assessment, diagnosis, and treatment planning remain king, which often necessitates the use of radiographic investigation or CBCT imaging. It is also crucial that clinicians have undergone the relevant training courses and gained sufficient qualifications to perform treatment safely and effectively. Where endodontic microsurgery is indicated and this is beyond the skill or clinical confidence of the general dental practitioner, referral to an endodontic specialist is indicated. Our team at EndoCare would be very happy to work with you to plan and execute the advanced treatment your patient needs – just get in touch today!

Patient-centred care

Endodontic microsurgery offers several advantages when performed in the right situations. Even if you don't offer the service directly, it is important to ensure that your patients are aware of all their options.

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