Success Rate of Apical Surgeries Performed in a Postgraduate Endodontic Fellowship. A Retrospective Observational Study
Keywords:
healing, prognostic factors, success rate.Abstract
Introduction: Apical surgeries are routinely performed in Endodontic postgraduate courses at institutions of higher education. Although the success rate and intraoperative prognostic factors of these interventions have been determined in previous studies, constant feedback is necessary for the revision and adjustment of the clinical protocols used.
Objective: To determine the success rate and intraoperative prognostic factors of apical surgeries performed in an endodontic postgraduate course.
Methods: Retrospective observational cross-sectional study based on the evaluation of clinical and radiographic records of patients undergoing apical surgeries. A total of 840 clinical records were reviewed, of which 97 recorded 108 apical surgeries. Fifty-two cases that met the inclusion criteria were finally selected. The intraoperative prognostic factors evaluated were: magnification, type of flap, retropreparation protocol, retro-obturation material and type of suture. Postoperative and control radiographs were evaluated by a previously calibrated observer using the Molven scale. Statistical analysis was performed using Minitab software, contingency tables and t-test.
Results: The success rate was 78.84%. A statistically significant decrease was observed in the Molven scale (p ≤ 0.001). It was not possible to establish the relationship of intraoperative prognostic factors with the success rate.
Conclusions: The apical surgeries performed showed an acceptable success rate and this could increase with long-term clinical and radiographic follow-ups.
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References
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
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