Case Selection and Treatment Planning in Endodontic Surgery: Clinical Decision-Making for Saving Teeth

In complex clinical scenarios, some dentists might just go straight to suggesting an extraction and implant. However, many patients still express a strong preference for saving their natural teeth—whether due to personal values, medical conditions, dental anxiety, or financial and philosophical reasons. When non-surgical root canal treatment is not feasible, endodontic microsurgery may offer a useful alternative. This presentation explores a comprehensive approach to case selection and treatment planning in endodontic surgery. Beyond evidence-based principles, a novel stepwise clinical sequence developed by the presenter will be introduced to guide decision-making in challenging cases. Clinical examples will include separated instruments, radicular cysts, root resorption, radicular grooves with periodontal involvement, canal transportation, perforations, and suspected vertical root fractures. Attendees will gain practical strategies for preoperative evaluation such as risk assessment, and surgical planning to achieve predictable, patient-centered outcomes.