AIM: Root canal treatment of teeth with necrotic pulps and apical periodontitis may be complicated by limited access to the root canals due to restorations and dystrophic calcifications. The objective of this study was to evaluate retrograde root canal as a primary treatment using a surgical approach as an alternative to conventional orthograde treatment. METHODOLOGY: Patients with apical periodontitis in the anterior region of the maxilla were consecutively recruited to the study over a period of 4 years. Fifty-seven patients met the inclusion criteria and received retrograde root canal treatment. A clinical and radiographic evaluation was made after 1 and 2 years postoperatively. RESULTS: Clinical and radiographically evaluation after 2 years revealed a successful outcome (as defined in this study) in 90% of the cases. CONCLUSION: Retrograde root canal as a primary treatment was a reliable alternative to treat apical periodontitis on single- and two-rooted teeth with limited orthograde access to the root canals in the maxilla.
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