PARENDODONTIC SURGERY: A CASE REPORT

Abstract

INTRODUCTION: Endodontics aims to prevent and treat pathological changes in the dental pulp and periapical tissues. Despite the standardized techniques, failures may occur, making paraendodontic surgery an alternative in cases of endodontic failure, especially in the face of persistent periapical lesions. Since the 1990s, endodontic microsurgery has advanced with the development of ultrasonic instruments and biomaterials, increasing success rates to up to 98%.CASE REPORT: A male patient presented with pain after endodontic treatment in tooth 22. Clinical examination revealed a fistula, confirmed by radiography and tomography, associated with a periapical lesion caused by extravasated obturator material. Surgery was performed with a quadrangular flap, exploratory osteotomy, and apical curettage. After removing 2 mm from the root apex, it was decided not to perform retrobturation, opting instead for referral for endodontic retreatment. Closure was done with simple sutures, and the patient was instructed for follow-up. DISCUSSION: The decision for surgery considered the persistent inflammation and limitations of conventional retreatment. Studies indicate that factors such as bacterial resistance and anatomical complexity influence endodontic failure. Surgery allows the repair of periapical tissues by eliminating infections and injuries. CONCLUSION: Paraendodontic microsurgery is effective in cases of endodontic failure, favoring tooth preservation and promoting tissue repair. Follow-up is essential to assess repair and prevent complications.