Periapical surgery of mandibular posterior teeth: anatomical and surgical considerations.

Periapical surgery is a well-accepted technique used to salvage endodontically involved teeth that cannot be satisfactorily treated or retreated by nonsurgical conventional endodontic procedures (1-4). Indications for periapical surgery are well described in the above mentioned endodontic references. Considering that the prognosis of success following endodontic surgery ranges from 60 to 89% (5-8), this procedure is a viable alternative to extraction or intentional replantation procedures of molar teeth not amenable to conventional root canal treatment (9, 10). However, it should be realized that, in comparison to conventional therapy, the success rate of surgical intervention is somewhat reduced (11 ). Caution should be exercised, specifically in periapical surgery of mandibular posterior teeth due to the potential damage of the mental and inferior alveolar neurovascular bundles (12). The purpose of this paper is to consider some important anatomical and surgical factors related to periapical surgery in this region.