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The purpose of the present study was to clinically and radiographically evaluate the periapical healing responses of patients with persistent apical periodontitis who were treated with microsurgical techniques and root-end fillings with mineral trioxide aggregate (MTA). Ninety-seven consecutive patients with 128 teeth demonstrating persistent periapical lesions were included in the study. A modern endodontic surgical protocol, which included mucoperiosteal flap elevation, an ostectomy, root-endfatcat:afckpjehxja47bdaqvmmgdgkwi