Endodontic microsurgery is a predictable, biologically sound solution for managing persistent periapical pathologies when nonsurgical treatment fails or is not feasible. Evolving from a last-resort procedure, it has been transformed by advances in magnification, microsurgical instruments, and biocompatible materials. Key factors influencing success include careful case selection, refined surgical techniques, and effective postoperative management. Technologies such as the dental operating microscope and ultrasonic instruments enable precise root-end resection and preparation. Modern materials like mineral trioxide aggregate (MTA) and bioceramics offer superior sealing and biocompatibility. Regenerative techniques, including guided tissue regeneration and autogenous grafts, further enhance healing, particularly in complex or periodontally compromised cases. With success rates now exceeding 90% in true endodontic lesions, endodontic microsurgery continues to advance through innovations like guided surgery and artificial intelligence, offering improved precision and long-term outcomes. This review underscores the importance of combining biological principles with technological innovation to achieve optimal results in endodontic microsurgery.
Rachana et al. (Wed,) studied this question.