A minimally-invasive apicoectomy on tooth 22 is demonstrated here by Dr. Wolf Richter, Munich/Germany. Following an overview of the initial situation and the patient's medical history, the surgical procedure begins with a sulcular incision and a vertical incision to provide relief. As the minimally-invasive apicoectomy continues, atraumatic preparation of the entire buccal flap layer is performed and the bone cavity opened so that the root end is exposed and visible.

Once the corticalis has been opened, particular attention is paid to the complete degranulation and cleaning of the bone cavity, which is a prerequisite for a successful minimally-invasive apicoectomy. This is often the most time-consuming step in the treatment process. Following retrograde preparation of the cavity and removal of the material used to fill the root canal, Dr. Richter provides a demonstration of retrograde root canal filling using MTA (a Portland cement), as well as subsequent wound closure. This is followed by a discussion of the subsequent therapy steps that have been planned and that are due to take place after the minimally-invasive apicoectomy.