[Analysis and management of the influence of periapical lesion size on endodontic microsurgery]

Endodontic microsurgery is a critical treatment option that is often considered when conventional root canal therapy fails or when complex periapical diseases cannot be resolved through non-surgical treatment. The clinical outcomes of endodontic microsurgery are influenced by multiple factors. Among these, the size of the periapical lesion is considered a key variable that can significantly impact surgical design, operative difficulty, postoperative infection control, and tissue healing. This article systematically discusses the mechanisms by which the size of periapical lesions affects the efficacy of endodontic microsurgery, preoperative assessment methods, intraoperative management strategies, and prognostic correlations. On the basis of existing evidence from evidence-based medicine, clinical management re-commendations are proposed to provide a theoretical foundation and operational guidance for clinical practice.