Even with ideal root canal therapy there may be persistent infection in a small number of patients. Fortunately there are options to still save natural teeth. Endodontic surgery is aimed at complex areas at the end of roots to help eliminate any remaining bacteria. The procedure is performed with the aid of a microscope to minimize trauma and get the best result possible. Using modern materials and techniques success rates for endodontic surgery are now around 90%! A recent review in the Journal of Endodontics (Feb. 2012) summarizes traditional success rates with modern endodontic surgery.
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