CLINICAL DECISION-MAKING IN SURGICAL AND NONSURGICAL ENDODONTICS: A REPORT OF TWO CASES

Abstract

The primary goal of endodontic therapy: Root canal systems must be cleaned and shaped: cleaned of their organic remnants and shaped to receive a three-dimensional hermetic/fluid-tight seal filling of the entire root canal space. However, prolonged intraradicular infection, missing canals, insufficient obturation, or coronal leakage, all can lead to treatment failure. Thus retreatment of the tooth becomes necessary in certain situations, leading to surgical or non-surgical endodontic procedures. Endodontic Retreatment is a procedure to remove root canal filling materials from the tooth followed by cleaning, shaping, and obturating the canals. (3) A nonsurgical retreatment approach should always be considered as the first line of management before proceeding with endodontic or periapical surgery. Diagnosis of the affected tooth plays a vital role in decision making of suitable treatment plan which must be carried out to have a favourable outcome. Decision-making should be based on case selection, root canal anatomy, periodontal status, and restorative considerations. Both surgical and non-surgical retreatment options are effective in managing failed endodontic cases. The integration of advanced techniques and biomaterials has enhanced prognosis for both modalities.