Apical periodontitis (AP) is a localized inflammation that induces the destruction of periradicular tissues, that is, the periodontal ligament and alveolar bone around the root apex. It generally occurs from damage to the dental pulp as a sequela of endodontic infection, physical trauma, or iatrogenic trauma. AP does not heal by itself; however, periapical tissue has the ability to heal if the cause of inflammation is eliminated. Therefore, AP treatment involves elimination of the microbial infection from the root canal and prevention of reinfection. This type of nonsurgical endodontic treatment is often preferred; however, nonsurgical treatment can fail for various reasons.2,3  The common factors affecting endodontic treatment failure include persistent bacterial infection, inadequate filling of the canal, leakage from improper sealing, an untreated canal, iatrogenic procedural errors, and complications from instrumentation.4,5 

Surgical endodontic treatment is considered in the case of conventional endodontic...

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