Endodontic Microsurgery: A Paradigm Shift in Modern Endodontic Practice

Abstract

Background: Endodontic microsurgery represents the evolution of traditional apical surgery, integrating magnification, illumination, microsurgical instruments, and biocompatible materials to manage persistent periapical pathologies that are not amenable to conventional root canal treatment alone. Aim: This review provides an updated overview of the principles, indications, advances, techniques, and clinical outcomes of endodontic microsurgery. Methods: A literature review was conducted using PubMed, Scopus, and Google Scholar databases for studies published in the last two decades focusing on clinical outcomes, microsurgical techniques, and recent innovations in endodontic microsurgery. Results: Modern microsurgical approaches demonstrate superior success rates compared to conventional techniques, primarily due to enhanced visualization, minimal invasive protocols, and the use of biocompatible root-end filling materials such as MTA and bioceramics. Conclusion: Endodontic microsurgery is a predictable treatment option when nonsurgical endodontic retreatment is not feasible or has failed. Continued advancements in microsurgical armamentarium and biomaterials promise to further improve treatment outcomes.