[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-209087-105":59,"doc-detail-209087-en":131},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":124,"head_meta":126,"extra_data":128,"updated_unix":130},105,"en","periapical-surgery-of-mandibular-posterior-teeth-anatomical-and-surgical-considerations","Periapical Surgery of Mandibular Posterior Teeth - Anatomical and Surgical Considerations","","Periapical surgery is an established method for salvaging endodontically involved mandibular posterior teeth when conventional nonsurgical treatment or retreatment cannot be completed satisfactorily. Indications are grounded in endodontic references, and the reported success rate after endodontic surgery ranges from 60% to 89%, making the approach a viable alternative to extraction or intentional replantation for selected molars. Surgical planning must account for reduced success compared with conventional therapy and exercise caution to avoid injury to mental and inferior alveolar neurovascular bundles.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/periapical-surgery-of-mandibular-posterior-teeth-anatomical-and-surgical-considerations/209087/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/periapical-surgery-of-mandibular-posterior-teeth-anatomical-and-surgical-considerations/209087.png","ImageObject",300,407,{"name":92,"@type":93},"Pentious","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-23","2026-09-05",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",16,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"When is periapical surgery for mandibular posterior teeth indicated?","Question",{"text":113,"@type":114},"It is indicated for salvaging endodontically involved teeth that cannot be satisfactorily treated or retreated with nonsurgical conventional endodontic procedures.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"What success rate range is reported for endodontic surgery?",{"text":118,"@type":114},"The success of endodontic surgery is described as ranging from 60% to 89%.",{"name":120,"@type":111,"acceptedAnswer":121},"What anatomical structures require special caution during mandibular posterior periapical surgery?",{"text":122,"@type":114},"Care is needed to avoid potential damage to the mental and inferior alveolar neurovascular bundles.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},209087,1788609052,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":29,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":130,"read_time":144},1374404730887,"https://ap-avatar.wpscdn.com/davatar_6f874abed73319feea01a86fa6f0fab8","# CLINICAL ARTICLES\n\nPeriapical Surgery of Mandibular Posterior Teeth:Anatomical and Surgical Considerations  \nLouis Lin,DMD,PhD,Joseph Skribner,DDS,Francis Shovlin,DDS,Ms,and Kaare Langeland,DDS,PhD  \nPeriapical surgery is a well-accepted technique usedto salvage endodontically involved teeth that cannotbe satisfactorily treated or retreated by nonsurgicalconventional endodontic procedures(1-4).Indica-tions for periapical surgery are well described in theabove mentioned endodontic references.Consideringthat the prognosis of success following endodonticsurgery ranges from 60 to 89%(5-8),this procedureis a viable alternative to extraction or intentional re-plantation procedures of molar teeth not amenable toconventional root canal treatment(9,10).However,itshould be realized that,in comparison to conventionaltherapy,the success rate of surgical intervention issomewhat reduced(11).Caution should be exercised,specifically in periapical surgery of mandibular pos-terior teeth due to the potential damage of the mentaland inferior alveolar neurovascular bundles(12).Thepurpose of this paper is to consider some importantanatomical and surgica factors related to periapicalsurgery in this region.  \n## ANATOMICAL CONSIDERATIONS\n\nMandibular Canal,Inferior Alveolar Nerve,andArtery  \nRadiographically,the mandibular canal is evi-denced by a radiolucent band.The canal variesgreatly in size and in its relationship to the roots of theposterior teeth(13).Often it closely proximates ormay even come in contact with the roots of the thirdmolar.Sometimes,it is in the proximity of the roots ofall mandibular molars(Fig.1).Anatomically,the man-dibular canal is situated lingually to the roots of pos-terior teeth.The inferior alveolar nerve is the largestbranch of the posterior division of the mandibularnerve.It runs vertically downward with the inferioralveolar artery from the infratemporal fossa,enteringthe mandibular foramen on the medial surface of theramus of mandible.It courses through the mandibularcanal in the body of the mandible and supplies allmandibular teeth and their supporting structures.The  \ninferior alveolar artery,a branch of the maxillary ar-tery,travels closely with the inferior alveolar nerve.  \nMental Foramen,Nerve,and Artery  \nThe mental foramen appears on radiograms as anoval or round radiolucent area in the mandibular pre-molar region.Its location varies in relationship to theroots of the premolars.Its image may be seen inferiorto,at the same level as,or superior to the root apices(13).It also may be situated directly over the root ofeither premolar,or between them(Figs.2 and 3).Sometimes,the communication between the mentalforamen and the mandibular canal can be seen(Fig.  \n4).The mental foramen is not always visible radio-graphically.The mental nerve,a branch of the inferioralveolar nerve,emerges with the mental artery throughthe mental foramen to supply the oral mucosa and theskin of the lower lip and chin.The mental artery s abranch of the inferior alveolar artery.  \nVestibular Fornix(Mucobuccal Fold)  \nThe depth of vestibular fornix varies and is limitedby bony ridges or prominences in the mandibularmolar area(14).If the vestibule fornix is deep,theoverlying buccal alveolar bone will be thin(Fig.5A).If the vestibule fornix is shallow,the buccal alveolarbone,overlying the roots of mandibular posteriorteeth,will be thick(Fig.5B).In general,the premolarsand first molar are close to the buccal alveolar plate,whereas the second and third molars are closer to thelingual plate(2).  \n## SURGICAL CONSIDERATIONSMandibular Canal and Inferior AlveolarNeurovascular Bundles\n\nTo avoid injury to the mandibular canal and itsneurovascular contents,it is essential to have undis-torted diagnostic radiographs to show the accuratelength of the involved teeth and its relation to the  \nFiG 1.Mandibular canal(arrows)in proximity to the roots of man-dibular molars.  \nFIG 2.Mental foramen(arrows)located at the apex of secondpremolar.  \nFiG 3.Mental fo","cbCaiqrKkFtgYkYQ","https://ap.wps.com/l/cbCaiqrKkFtgYkYQ","pdf",947262,"English","# Clinical Articles\n## Anatomical Considerations\n## Mandibular Canal, Inferior Alveolar Nerve, and Artery\n## Mental Foramen, Nerve, and Artery\n## Vestibular Fornix (Mucobuccal Fold)\n## Surgical Considerations\n## Mandibular Canal and Inferior Alveolar Neurovascular Bundles","[{\"question\":\"When is periapical surgery for mandibular posterior teeth indicated?\",\"answer\":\"It is indicated for salvaging endodontically involved teeth that cannot be satisfactorily treated or retreated with nonsurgical conventional endodontic procedures.\"},{\"question\":\"What success rate range is reported for endodontic surgery?\",\"answer\":\"The success of endodontic surgery is described as ranging from 60% to 89%.\"},{\"question\":\"What anatomical structures require special caution during mandibular posterior periapical surgery?\",\"answer\":\"Care is needed to avoid potential damage to the mental and inferior alveolar neurovascular bundles.\"}]","Periapical Surgery of Mandibular Posterior Teeth - Anatomical and Surgical Considerations | PDF",15]