**4. Assessment for surgical procedures**

The basic purpose of periapical surgery can be determined as follows:


In order to achieve these goals, following principles have to be estimated:

Preoperatively;

**•** Developing a surgical diagnosis

Intraoperatively;


**•** Haemostasis

**•** Fracture of apical third of the root

**•** Teeth damaged beyond restoration

**3. Contraindications**

**•** Traumatic occlusion **•** Poor root crown ratio

**•** Elimination of disease **•** Prevention of disease

Preoperatively;

Intraoperatively;

**•** Flap design

**•** Aseptic technique

**•** Tissue handling

etc.

**•** Draining sinus tract/nonresponsive to RCT

210 A Textbook of Advanced Oral and Maxillofacial Surgery Volume 2

**•** Formation of periapical granuloma or odontogenic cyst related with apex

**•** Presence of systemic diseases—leukaemia, uncontrolled diabetes, anaemia, thyrotoxicosis,

**•** Extension of root canal sealant cement/filling beyond the apex

**•** Teeth with deep periodontal pockets and grade III mobility

**•** Acute infection which is nonresponsive to the treatment **•** Anatomic structures (e.g., adjacent nerves and vessels)

The basic purpose of periapical surgery can be determined as follows:

In order to achieve these goals, following principles have to be estimated:

**•** Structures interfere with access and visibility

**4. Assessment for surgical procedures**

**•** Removal of damaged or redundant tissue

**•** Improvement of function and esthetics.

**•** Developing a surgical diagnosis


Post operatively;

