Occasionally very large periapical lesions may enlarge after adequate debridement and obturation. These lesions are generally best resolved with decompression and limited curettage to avoid damaging adjacent structure such as mandibular nerve. The continuous apical leakage lead to expanding lesion and root resection with placement of an apical seal can resolve the lesion. …show more content…
The goal of endodontic treatment is to seal al the pathways of communication between the pulpal and Periapical tissues. A necessary requirement of root canal treatment is that the obturation and restoration of the tooth must seal the root canals both apically and coronally to prevent leakage and percolation of oral fluids and to prevent recontamination of disinfected canals. Apicoectomy (apicectomy / root-end resection) with retrograde obturation is a widely applied procedure in endodontic, when all attempts for the successful completion of orthogrde endodontic treatment have failed. Failure of non-surgical endodontic treatment or non-surgical endodontic retreatment indicates the need for apicectomy to save the tooth. As most endodontic failures occur as a result of leakage of irritants and microbes from infected root canals, the retrograde filling material must provide an adequate apical seal and be biocompatible. Its anti-bacterial effects and ability to stimulate regeneration of the periodontium will accelerate the healing process and reduce the incidence of