Cirurgia Parendodôntica: manejo cirúrgico de desvio de canal e lesão Periapical – relato de caso clínico

Abstract

INTRODUCTION: Endodontic intervention consists of an approach that aims to eliminate infection from the root canal system and prevent its installation. Its importance lies in preserving the tooth structure, avoiding extractions of teeth compromised by periapical lesions, infections and other conditions. The surgical technique consists of removing pathological tissue, retropreparation and apical obturation, promoting infection control. In this therapeutic modality, the use of biocompatible cements, such as Sealapex, contributes to apical sealing and favors the repair of periapical tissues. OBJECTIVE: To report a clinical case of a patient who underwent endodontic surgery on a tooth with deviation from the original canal trajectory, associated with periapical lesion and complex anatomy. METHODOLOGY: This is a literature review and case report on endodontic surgery on a tooth with deviation from the original canal trajectory and periapical lesion. RESULTS: The results of the study showed that endodontic surgery on a tooth with deviation from the original canal trajectory, associated with periapical lesion, is effective, due to its potential for efficiency in canals with sharp curvature, high success rate and preservation of the tooth even after failures in conventional endodontic treatment. The patient presented good healing and absence of complications in the postoperative period, demonstrating that the procedure, although invasive, presented satisfactory results. FINAL CONSIDERATIONS: This study, combined with the analysis of the clinical case, demonstrated the effectiveness of endodontic surgery in teeth with deviation from the original root canal path, periapical lesion and complex anatomy. It was observed that this intervention has been consolidated as an efficient therapeutic alternative, especially in situations of chronic periapical abscess in which conventional endodontic treatment does not present satisfactory results. The application of ultrasonic instruments in the apicoectomy provided greater precision and preservation of the dental element. In addition, the use of Sealapex cement contributed to an effective apical sealing and favored the tissue repair process. The combination of these techniques proved to be highly effective in resolving chronic infection, reinforcing the predictability and success of endodontic surgery in complex cases, without the occurrence of postoperative complications.