Efficacy Of Modified Minimally Invasive Apical Microsurgery

To evaluate the clinical efficacy of modified minimally apical microsurgery in treating refractory apical periodontitis, providing evidence for expanding its indications and optimizing extra-radicular infection management. The randomized controlled study included 68 patients (74 single-rooted teeth) diagnosed with chronic apical periodontitis (post-endodontic treatment) from February 2021 to February 2024. Patients were randomly assigned to an experimental or control group. The experimental group underwent modified minimally invasive apical microsurgery, involving a root-end resection of ≤1 mm, Er:YAG laser disinfection with auxiliary sealing, and a 3 mm retrograde preparation and filling. The control group underwent traditional apical microsurgery with a 3 mm root-end resection, 3 mm retrograde preparation, and filling. Follow-ups were conducted at 3, 6, and 12 months, assessing subjective symptoms, clinical examination, and radiographic examination. The 1-year cumulative clinical and radiographic success rate was 91.8% for traditional apical microsurgery while 93% for modified apical microsurgery. No significant differences were observed between groups at 3, 6, and 12 months (P > 0.05). Modified minimally invasive apical microsurgery is as effective as the traditional approach while preserving more root structure for better support.So it can be a preferred clinical option in treating refractory apical periodontitis.