Selective Curettage: A Conservative Microsurgical Approach to Treating Large and Complicated Lesions

Area of Science:

• Endodontics
• Oral Surgery
• Dental Imaging

Background:

• Endodontic microsurgery is effective, but large lesions pose challenges.
• Invasion of adjacent anatomical structures complicates traditional curettage.
• Risk of complications and damage to vital structures is high with complete curettage.

Purpose of the Study:

• To evaluate the efficacy of selective curettage in endodontic microsurgery.
• To assess a conservative approach for managing extensive periapical lesions.
• To determine the safety and outcomes of selective curettage in complex cases.

Main Methods:

• Selective curettage removed 50%-70% of granulomatous tissue.
• Procedures were guided by 3D cone-beam computed tomography (CBCT) and 2D periapical radiographs.
• Clinical follow-ups assessed healing and complications.

Main Results:

• All cases demonstrated successful healing, either complete or with scar tissue formation.
• Selective curettage successfully avoided damage to neighboring vital structures.
• No untoward results or significant complications were reported post-procedure.

Conclusions:

• Selective curettage is a safe and effective conservative alternative for endodontic microsurgery.
• This approach minimizes risks associated with complete curettage of invasive lesions.
• Successful outcomes support selective curettage for complex periapical pathologies.