Consideration of indications for endodontic microsurgery

Posttreatment disease is a difficult clinical problem. Periradicular surgery is an important and effective method for cases that cannot be resolved by root canal therapy. In recent years, with the application of microscope for oral surgery and the development of microsurgical instruments, microsurgery in endodontics has reduced treatment trauma compared to traditional periradicular surgery and further improved the success rate of clinical treatment. However, as an invasive surgical method, the indications and timing of microsurgery in endodontics should be strictly defined for clinical applications. This paper reviews the literature on this important issue and discusses it with regard to the clinical experience of the author′s team. Explaining the effective root canal retreatment and good coronary closure are the primary considerations when posttreatment disease occurs. When root canal retreatment fails or cannot be completed after the initial treatment, the anatomical factors, lesion extent and periodontal lesion combination should be fully considered, and the microsurgery treatment strategy should be carefully formulated.