Apical Microsurgery Of Anterior Teeth: A Case Report

This report comprehensively presents the treatment process of apical microsurgery for a radicular cyst in the left anterior maxillary tooth of a 22-year-old male. The patient's chief complaint was swelling and pain in the gums of the left anterior maxillary tooth for over a week. This tooth had suffered trauma 4 years ago and undergone root canal retreatment. Clinical examination revealed a discolored crown (tooth #21) with a resin filling. CBCT shows: There is a radiolucent image in the apical area of tooth #21.We performed a gingival flap in the anterior maxillary region, removed part of the diseased bone tissue, and exposed the apical region. We resected 3 mm of the apical tip. After apical retro-preparation, we performed retro-filling with i-Root BP plus(Innovative BioCeramix Inc,Vancouver,BC,Canada). Subsequently, we replaced and sutured the gingival flap, and took a postoperative radiograph.After 3 months of follow-up, the bone resorption area around the apical region regenerated well. Apical microsurgery should thoroughly scrape away the inflammatory granulation tissue in the apical region to expose a clear and intact apical tip, ensuring that the apical region is free from infection and facilitating the regeneration of soft and hard tissues in the surgical wound. The success of apical microsurgery requires precise surgical techniques and a sterile surgical environment. Thorough debridement and maintaining the sealing of the apical region are the most crucial steps in apical microsurgery.