Microsurgical Endodontics

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Jouanny, Guillaume Khayat, Bertrand
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Microsurgical Endodontics

Bertrand Khayat / Guillaume Jouanny

Choosing the right approach to endodontic treatment is important because failure can lead directly to extraction.
Endodontic surgery is a therapeutic solution that is too often overlooked, which is surprising given that it is a reliable technique with a very high success rate.
Not only is endodontic surgery more conservative than conventional endodontic treatment, but it can also be used to resolve difficulties that are inaccessible by conventional approach.
Written by two specialists in the discipline, this book outlines predictable surgical strategies and presents more than a hundred clinical cases through each stage of treatment.
This book provides concrete and practical information so that endodontists who want to implement surgical techniques can approach their first cases with the knowledge they need.


  1. Indications
    Presence of a lesion after a satisfactory treatment or retreatment
    • Presence of a lesion after a nonsatisfactory treatment or retreatment
    • Failure of a previous surgery
    • Surgical treatment as the sole treatment: retrograde root canal treatment
  2. Contraindications
    Medical contraindications
    • Local contraindications
  3. Preoperative examination, prescriptions, informed consent and postoperative instructions
    Preoperative examination
    • Prescriptions in endodontic surgery
    • Informed consent and postoperative instructions
  4. Optical aids and armamentarium
    Optical aids
    • Instrumentation and materials
  5. Ergonomics and working positions
    Work environment
    • Practitioner’s position
    • Patient and microscope position
    • Four-handed work in endodontic surgery
  6. Anesthesia
    • Anesthesia protocol
  7. Soft tissue anatomy and incision design
    Soft tissue anatomy
    • Incisions
    • Different types of flaps
    • Flap designs
  8. Flap elevation and suturing
    Flap elevation and retraction
    • Sutures
  9. Osteotomy, resection, curettage and hemostasis
    • Apical resection
    • Curettage
    • Hemostasis
    • Precautions per area
    • Biopsy
  10. Retrograde canal preparation
    Objectives of retrograde canal preparation
    • Ultrasonics
    • Technical guide
  11. Retrograde obturation
    Root-end filling materials
    • Technique
  12. Outcome, regenerative procedures and complications
    • Regenerative procedures
    • Postoperative patient management
    • Complications



Dr. Bertrand Khayat received his DDS degree at the University of Paris. He obtained his Certificate in Endodontics and his Masters of Science at the University of Washington in 1988. A pioneer in the use of the microscope in Endodontics, he also designed several surgical instruments including ultrasonic tips for surgical retropreparation. In addition to his extensive experience and expertise in Endodontic Surgery, he lectures internationally while maintaining his private practice in Conventional and Surgical Endodontics in Paris.

Dr. Guillaume Jouanny received his DDS degree at the University of Paris. He earned his Certificate in Endodontics from the University of Pennsylvania in 2015, where he received comprehensive training in Microsurgical Endodontics. He returned to France where he teaches at the University level. In addition to his private practice in Paris, he lectures on Surgical Endodontics, among other Endodontic topics, worldwide.

The authors have collaborated for the last decade on multiple publications and a textbook dedicated to Endodontic Microsurgery in French.
Together, they founded a clinical training program that welcomes international dentists seeking mastery in Surgical Endodontics.