Is an apicoectomy ever successful? if so, under what conditions? A historical assessment with contemporary overtones

In 1921, Dr. Thomas R Hinman of Atlanta, Georgia read a paper before the First district Dental Society in New York City that dealt with the management of infected teeth. Adherents of the theories of focal infection and elective localization advocated the extraction of teeth with necrotic pulps and particularly those with periapical lesions. In his presentation, Dr. Hinman overlooked the procedures of root amputation or apicoectomy (terms that were was synonymous at that time), stating that the technique had been abandoned as a failure by oral surgeons. Dr. Hinman later claimed that he had been misunderstood, and that what he really meant was that apicoectomy is only rarely successful. Out of this incident there appeared a lengthy symposium, with contributions from across the United States. While this debate ensued, the techniques of this procedure were being applied and evaluated in the European sector, with a number of treatises expounding on their versatility, acceptability, and applicability far beyond what was being addressed in the United States. This paper will focus on some of the unique historical perspectives from all parties, and clarify these perspectives relative to contemporary philosophies and rationales.