SURGICAL MANAGEMENT OF PERIAPICAL PATHOLOGY RELATED TO MANDIBULAR MOLARS USING BUCCAL BONE LID APPROACH

Introduction: Periapical surgery (Apicectomy) is considered line of treatment for the untreated chronic periapical pathology. Apicectomy of mandibular molars is technically more difficult to perform than is the same procedure on anterior teeth and premolars because of anatomical reasons. The innovation of bone cutting technique using piezoelectric device facilitated this procedure through buccal bone lid approach. Aim of the study: The objective of this study was to evaluate clinically and radiographically apicectomy with endodontic treatment for mandibular molars affected with chronic periapical pathology using buccal bone lid technique.Materials and methods: Twelve patients diagnosed with chronic periapical pathology related to mandibular molars that are indicated for apicectomy and Root canal treatment (RCT) using buccal bone lid on basis of Cone Beam Computed Tomography (CBCT). Clinical follow-up was conducted at 1 week, 2 weeks, 1 month, and 6 months intervals. The radiographic evaluation was assessed at immediately postoperative and after 6 months to evaluate the healing of bone density, volume and area analysis.Results: Upon clinical evaluation, post-operative pain and edema were present immediately postoperatively, and disappeared completely after two weeks. Normal inferior alveolar nerve response and normal mouth opening were recorded for all patients as well. The radiographic evaluation after 6 months showed increase in bone density and decrease in volume of bone defect,Conclusion: This study concluded that buccal bone lid surgery is efficient for apicectomy to mandibular molars offended with chronic periapical pathology, permitting proper visibility, accessibility and high success rate of bone healing.