Clinical case report of non-surgical and surgical endodontic treatment (apicoectomy)

Endodontic treatment, both non-surgical and surgical, aims to eliminate the neurovascular bundle and the microbiota present within the root canal system and the extraradicular region. This study reports the clinical management of a 31-year-old female patient with odontalgia in tooth #46. Following clinical and radiographic evaluation, a periapical radiolucent lesion approximately 5 mm in diameter was identified. Initially, conventional endodontic treatment was performed using the Reciproc Blue mechanized system, followed by an apicoectomy due to persistent symptoms associated with a high bacterial load. The therapeutic approach was based on the review of 12 scientific articles to establish an accurate pulp and periapical diagnosis and to select appropriate techniques and materials. Treatment outcomes demonstrated adequate healing and periapical repair, with resolution of clinical symptoms and functional improvement of the treated tooth. It is concluded that the integration of non-surgical and surgical treatments is essential in cases of pulp necrosis and chronic periapical abscess with high bacterial load. This complementary approach optimizes therapeutic outcomes, preserves the tooth, and improves the patient’s quality of life