Darwin’s theory of evolution is based on natural selection. The basic framework of endodontic surgery by incorporation of interdisciplinary precepts has evolved into endodontic microsurgery. Advances in the surgical armamentarium based on biological concepts has enabled a microsurgical approach which ensures enhanced positive treatment outcomes. The past is not being rejected; the future is being embraced. It is the natural progression of all things.
A new era in endodontic surgery has begun. Microscopes, surgical stents, piezotomes, retropreparations perpendicular to the long axis the tooth, ultrasonic tips, bioceramic putty, bone grafting and membranes and 6-0 monofilament sutures have altered the percentage of positive treatment outcomes to an unprecedented degree.