Nonsurgical endodontic retreatment using a bioceramic sealer after apical surgery: a case series

Material and methods. This article presents a series of clinical cases of nonsurgical retreatment of teeth previously subjected to apical surgery. Discussion. Despite the technical challenges associated with altered root anatomy after apicoectomy, nonsurgical endodontic retreatment resulted in a stable clinical outcome and radiographically confirmed healing of the periapical tissues. The use of the bioceramic sealer BioRoot RCS (Septodont, France) as an apical barrier material provided reliable apical sealing and contributed to bone regeneration in the periapical area, supporting the clinical effectiveness of calcium silicate-based cements in the management of chronic apical periodontitis. In the first clinical case, a 2-year follow-up demonstrated complete restoration of bone architecture in the periapical region and the absence of inflammatory signs; in the second case, a 1-year follow-up revealed a marked reduction in the extent of periapical bone destruction and evidence of active tissue repair. Conclusions. The use of bioceramic materials in nonsurgical retreatment of teeth previously managed surgically may be considered an effective and biologically sound approach for managing complex post-surgical conditions and achieving predictable clinical outcomes in the treatment of chronic apical periodontitis.