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N o a p i c e c t o m y i n e n d o d o n t i c s u r g e r y Zero apicectomy in endodontic microsurgery Randa Harik,a Grace Issaa & Philippe Sleimana, b a Faculty of Dentistry, Lebanese University, Beirut, Lebanon b Department of Endodontics, Faculty of Dentistry, Lebanese University, Beirut, Lebanon; Adj Asst Prof. School of Dentistry, Department of Endodontics, University of North Carolina at Chapel Hill, Chapel Hill, N.C., U.S. C o r r e s p o n d i n g a u t h o r : Prof. Philippe Sleiman Dekwaneh SLAF St. 5th floor Mimosa bldg. Beirut Lebanon T + 96 114 94 779 profsleiman@gmail.com H o w t o c i t e t h i s a r t i c l e : Harik R, Issa G, Sleiman P. Zero apicectomy in endodontic microsurgery. J Oral Science Rehabilitation. 2017 Sep;3(3):18–26. Abstract B a c k g r o u n d Surgical endodontic treatment is an option for teeth with periapical perio- dontitis and may be indicated for teeth previously submitted to unsuccess- ful endodontic treatment and teeth with a strong possibility of failure by the nonsurgical approach. This procedure includes root sectioning and preparation of a cavity in the root canal followed by retrograde obturation. Furthermore, the presence of apical true cysts requires surgical treat- ment as well, as these cysts are less likely to heal by nonsurgical root canal therapy because they are self-sustaining and no longer dependent on the presence or absence of root canal infection. Accordingly, surgical intervention of apical true cysts is necessary. The limitations of periapical radiography have led to significant inter- est in cone beam computed tomography (CBCT) in endodontic applica- tions. The number of CBCT scans taken every year is increasing as aware- ness increases, resolution increases and costs decrease. C a s e p r e s e n t a t i o n In this article, we describe a new approach in surgical endodontics that focuses on preserving the integrity of the apical part of the root. This approach entails conducting root canal treatment and surgical cyst removal in one session. We illustrate this approach with a series of cases showing the preoperative condition and postoperative healing, with a recall period of 6 months, 1 year, 2 years, and yearly up to 5 years. C o n c l u s i o n Zero apicectomy in endodontic surgery is a novel technique that combines high-resolution CBCT visualization of the apical situation, root canal treatment with the use of e(cid:2)icient irrigation with EndoVac, and root surface conditioning in order to allow the preservation of the apical part of the root ad integrum. Zero apicectomy clears the infection from inside the bone and treats the root canal in the same session, giving the body a greater opportunity to heal in a healthy, clean environment. Current lit- erature has not described this technique; however, clinical cases have proven its success. K e y w o r d s Apicectomy, EndoVac, CBCT, surgical endodontic treatment. 18 Volume 3 | Issue 3/2017 Journal of Oral Science & Rehabilitation