The aim of this investigation was to review the surgical factors related to ostectomy in periapical surgery and their relationship to prognosis. An update was made of different techniques to achieve adequate access to the periapical lesion. Visual control of the affected roots is important for a successful result in periapical surgery; for this reason, the bone tissue from the vestibular cortical bone must be removed through an ostectomy or osteotomy. The technique used and the amount of bone removed must be analyzed preoperatively, since it will have a direct relationship to the surrounding anatomical structures, the healing time and the need to perform bone regeneration techniques. With the use of microsurgical techniques, the size of the ostectomy should not exceed 5 mm in order to reduce the healing time and thus improve the prognosis of periapical surgery. Osteotomy is an alternative technique that allows preservation of the external cortical bone, but has been little studied.
KeywordsOstectomy; osteotomy; periapical surgery; endodontic surgery; prognosis.
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COLOGNE, Germany: Caries and periodontitis are the two most common oral diseases in the world. Periodontitis affects around half of all adults globally, and severe cases are found among 10–15 per cent of the population, increasing with age. The build-up of plaque around the teeth is the most important risk factor for the development of periodontitis. Besides its role in the treatment process, high-quality oral hygiene is therefore of the utmost importance to prevent the disease from developing and to prevent the disease from coming back and causing further bone loss. Studies show that a manual toothbrush used alone reduces plaque scores by 42 per cent on average and does not reach the interdental surfaces. Consequently, additional tools for interdental cleaning, such as floss, toothpicks or interdental brushes, are needed. The recommendation about which tools to use must always be individually tailored and based on clinical experience and scientific knowledge.