Publique un comentario 
Descargar PDF
Tasa de éxito de cirugías apicales realizadas en un posgrado de Endodoncia. Un estudio observacional retrospectivo
Resumen
Introducción: Las cirugías apicales se realizan de forma rutinaria en los posgrados de Endodoncia en instituciones de educación superior. Aunque la tasa de éxito y los factores pronósticos intraoperatorios de estas intervenciones se han determinado en estudios previos, es necesario una retroalimentación constante para la revisión y ajuste de los protocolos clínicos utilizados.
Objetivo: Determinar la tasa de éxito y los factores pronósticos intraoperatorios de cirugías apicales realizadas en un posgrado de Endodoncia.
Métodos: Estudio observacional retrospectivo de corte transversal basado en la evaluación de registros clínicos y radiográficos de pacientes sometidos a cirugías apicales. Se revisó un total de 840 historias clínicas, de las cuales 97 registraron 108 cirugías apicales. Se seleccionaron finalmente 52 casos que cumplieron con los criterios de inclusión. Los factores pronósticos intraoperatorios evaluados fueron: la magnificación, el tipo de colgajo, el protocolo de retropreparación, el material de retroobturación y el tipo de sutura. Las radiografías posoperatorias y de control se evaluaron por un observador previamente calibrado, utilizando la escala de Molven. El análisis estadístico se realizó utilizando el software Minitab, tablas de contingencia y la prueba t.
Resultados: La tasa de éxito fue del 78,84 %. Se observó una disminución estadísticamente significativa en la escala de Molven (p ≤ 0,001). No fue posible establecer la relación de los factores pronósticos intraoperatorios con la tasa de éxito.
Conclusiones: Las cirugías apicales realizadas mostraron una tasa de éxito aceptable y esta podría aumentar con seguimientos clínicos y radiográficos a largo plazo.
Palabras clave
Referencias
Johnson BR, Fayad MI, Witherspoon DE. Periradicular Surgery. En: Hargreaves KM, Cohen S, editors. Cohen’s Pathway of the Pulp. 10th edn. St. Louis. MO: Elsevier; 2011. p. 720-76.
von Arx T. Apical surgery: a review of current techniques and outcome. Saudi Dent J 2011;23:9-15. DOI: https://doi.org/10.1016/j.sdentj.2010.10.004
Pinto D, Marques A, Pereira JF, Palma PJ, Santos JM. Long-term prognosis of endodontic microsurgery-a systematic review and meta-analysis. Medicina (Kaunas). 2020;56(9):447. DOI: https://doi.org/10.3390/medicina56090447
Kim S, Kratchman S. Modern endodontic surgery concepts and practice: a review. J Endod 2006;32(7):601-23. DOI: https://DOI.org/10.1016/j.joen.2005.12.010
Setzer FC, Kohli MR, Shah SB, Karabucak B, Kim S. Outcome of endodontic surgery: a meta-analysis of the literature-Part 2: Comparison of endodontic microsurgical techniques with and without the use of higher magnification. J Endod. 2012;38(1):1-10. DOI: https://doi.org/10.1016/j.joen.2011.09.021
Safi C, Kohli MR, Kratchman SI, Setzer FC, Karabucak B. Outcome of endodontic microsurgery using mineral trioxide aggregate or root repair material as root-end filling material: a randomized controlled trial with cone-beam computed tomographic evaluation. J Endod. 2019;45(7):831-9. DOI: https://doi.org/10.1016/j.joen.2019.03.014
Saunders WP. A prospective clinical study of periradicular surgery using mineral trioxide aggregate as a root-end filling. J Endod 2008;34(6):660-5. DOI: https://doi.org/10.1016/j.joen.2008.03.002.
Tsesis I, Rosen E, Taschieri S, Telishevsky Strauss Y, Ceresoli V, Del Fabbro M. Outcomes of surgical endodontic treatment performed by a modern technique: an updated meta-analysis of the literature. J Endod. 2013;39(3):332-9. DOI: https://doi.org/10.1016/j.joen.2012.11.044
Kohli MR, Berenji H, Setzer FC, Lee S-M, Karabucak B. Outcome of endodontic surgery: a meta-analysis of the literature—part 3: comparison of endodontic microsurgical techniques with 2 different root-end filling materials. J Endod. 2018;44(6):923-31. DOI: https://doi.org/10.1016/j.joen.2018.02.021
von Arx T, Jensen SS, Janner SFM, Hänni S, Bornstein MM. A 10-year follow-up study of 119 teeth treated with apical surgery and root-end filling with mineral trioxide aggregate. J Endod. 2019;45(4):394-401. DOI: https://doi.org/10.1016/j.joen.2018.12.015
Molven O, Halse A, Grung B. Incomplete healing (scar tissue) after periapical surgery-radiographic findings 8 to 12 years after treatment. J Endod. 1996;22(5):264-8. DOI: https://doi.org/10.1016/s0099-2399(06)80146-9
Lai P-T, Wu S-L Huang C-Y, Yang S-F. A retrospective cohort study on outcome and interactions Among prognostic factors of endodontic microsurgery. J Formos Med Assoc. 2022;121(11):2220-6. DOI: https://doi.org/10.1016/j.jfma.2022.04.005
Huang S, Chen NN, Yu VSH, Lim HA, Lui JN. Long-term success, and survival of endodontic microsurgery. J Endod. 2020;46(2):149-57. DOI: https://doi.org/10.1016/j.joen.2019.10.022
Öğütlü F, Karaca İ. Clinical and radiographic outcomes of apical surgery: a clinical study. J Maxillofac Oral Surg. 2018;17(1):75-83. DOI: https://doi.org/10.1007/s12663-017-1008-9
Liu SQ, Chen X, Wang XX, Liu W, Zhou X, Wang X. Outcomes, and prognostic factors of apical periodontitis by root canal treatment and endodontic microsurgery-a retrospective cohort study. Ann Palliat Med. 2021;10(5):5027-45. DOI: https://doi.org/10.21037/apm-20-2507.
Song M, Kim HC, Lee W, Kim E. Analysis of the cause of failure in nonsurgical endodontic treatment by microscopic inspection during endodontic microsurgery. J Endod. 2011;37(11):1516-9. DOI: https://doi.org/10.1016/j.joen.2011.06.032.
Jadun S, Monaghan L, Darcey J. Endodontic microsurgery. Part two: armamentarium and technique. British Dent J. 2019;227(2):101-11. DOI: https://doi.org/10.1038/s41415-019-0516-z
Rubinstein RA, Kim S. Short-term observation of the results of endodontic surgery with the use of a surgical operation microscope and super-EBA as root-end filling material. J Endod. 1999;25(1):43-8. Disponible en: https://www.sciencedirect.com/search?pub=Journal%20of%20Endodontics&cid=273486&qs=Short-term%20observation%20of%20the%20results%20of%20endodontic%20surgery%20with%20the%20use%20of%20a%20surgical%20operation%20microscope%20and%20super-EBA%20as%20root-end%20filling%20material.
Palma, PJ, Marques JA, Casau M, Santos A, Caramelo FF, Falacho RI, et al. Evaluation of root-end preparation with two different endodontic microsurgery ultrasonic tips. Biomedicines. 2020;8(383):1-19. DOI: https://doi.org/10.3390/biomedicines8100383.
De Lange J, Putters T, Baas EM, Van Ingen JM. Ultrasonic root-end preparation in apical surgery: a prospective randomized study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2007;104:841-5. DOI: https://doi.org/10.1016/j.tripleo.2007.06.023
Christiansen R, Kirkevang LL, Hørsted-Bindslev P, Wenzel A. Randomized clinical trial of root-end resection followed by root-end filling with mineral trioxide aggregate or smoothing of the orthograde gutta-percha root filling--1-year follow-up. Int Endod J. 2009;42(2):105-14. DOI: https://doi.org/10.1111/j.1365-2591.2008.01474.x
Eskandar RF, AlhHabib MA, Barayan MA, Edrees HY. Outcomes of endodontic microsurgery using different calcium silicate-based retrograde filling materials: a cohort retrospective cone-beam computed tomographic analysis. BMC Oral Health. 2023;23(1):70. DOI: https://doi.org/10.1186/s12903-023-02782-w
Setzer FC, Kratchman SI. Present status and future directions: surgical endodontics. Int Endod J. 2022;55(Suppl. 4):1020-58. DOI: https://doi.org/10.1111/iej.13783
Zhang MM, Fang GF, Wang ZH, Liang YH. Clinical outcome and predictors of endodontic microsurgery using cone-beam computed tomography: a retrospective cohort study. J Endod. 2023;49(11):1464-71. DOI: https://doi.org/10.1016/j.joen.2023.08.011
Bieszczad D, Wichlinski J, Kaczmarzyk T. Treatment-related factors affecting the success of endodontic microsurgery and the influence of GTR on radiographic healing-a cone-beam computed tomography study. J Clin Med. 2023;12(19):6382. DOI: https://doi.org/10.3390/jcm12196382
