restoration in the root apex. The dentist may use an
hemostatic agents are carefully removed to avoid
ultrasonic or a high-speed handpiece with a bur to
dropping scraps or cement into the incision. The site
prepare the blunted apex for the filling. When the
may be irrigated and aspirated again.
preparation is complete, the surgical site is irrigated
carefully with saline solution and aspirated until it is
A radiograph is exposed to determine the absence
dried thoroughly. Hemostatic agents such as bovine
of any filling particles in the tissue at the surgical site.
collagen or ferric sulfate may be placed to control
When it is determined that the filling is satisfactory and
that all particles of the filling material are removed,
bleeding and to catch scraps during the placement and
sutures are placed to close the incision. The surgical
condensation of the root end filling material.
portion of the apicoectomy is done quickly. The longer
Intermediate restorative material such as ZOE, or
the patient is subjected to a surgical procedure, the
super EBA cement (ethoxybenzoic acid) is mixed and
more likely it is that there will be swelling and
placed into the recessed preparation of the root apex.
discomfort. Follow-up appointments usually are
The retrograde filling is condensed and smoothed even
scheduled periodically for radiographs of the restored
with the tip of the amputated root surface. The