Five-year longitudinal assessment of the prognosis of apical microsurgery
Research output: Contribution to journal › Journal article › Research › peer-review
INTRODUCTION: Apical surgery is an important treatment option for teeth with post-treatment apical periodontitis. Knowledge of the long-term prognosis is necessary when weighing apical surgery against alternative treatments. This study assessed the 5-year outcome of apical surgery and its predictors in a cohort for which the 1-year outcome was previously reported.
METHODS: Apical microsurgery procedures were uniformly performed using SuperEBA (Staident International, Staines, UK) or mineral trioxide aggregate (MTA) (ProRoot MTA; Dentsply Tulsa Dental Specialties, Tulsa, OK) root-end fillings or alternatively Retroplast capping (Retroplast Trading, Rorvig, Denmark). Subjects examined at 1 year (n = 191) were invited for the 5-year clinical and radiographic examination. Based on blinded, independent assessment by 3 calibrated examiners, the dichotomous outcome (healed or nonhealed) was determined and associated with patient-, tooth-, and treatment-related variables using logistic regression.
RESULTS: At the 5-year follow-up, 9 of 191 teeth were unavailable, 12 of 191 teeth were extracted, and 170 of 191 teeth were examined (87.6% recall rate). A total of 129 of 170 teeth were healed (75.9%) compared with 83.8% at 1 year, and 85.3% were asymptomatic. Two significant outcome predictors were identified: the mesial-distal bone level at ≤ 3 mm versus >3 mm from the cementoenamel junction (78.2% vs 52.9% healed, respectively; odds ratio = 5.10; confidence interval, 1.67-16.21; P < .02) and root-end fillings with ProRoot MTA versus SuperEBA (86.4% vs. 67.3% healed, respectively; odds ratio = 7.65; confidence interval, 2.60-25.27; P < .004).
CONCLUSIONS: This study suggested that the 5-year prognosis after apical microsurgery was 8% poorer than assessed at 1 year. It also suggested that the prognosis was significantly impacted by the interproximal bone levels at the treated tooth and by the type of root-end filling material used.
Original language | English |
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Journal | Journal of Endodontics |
Volume | 38 |
Issue number | 5 |
Pages (from-to) | 570-9 |
Number of pages | 10 |
ISSN | 0099-2399 |
DOIs | |
Publication status | Published - May 2012 |
- Aluminum Compounds/therapeutic use, Alveolar Process/pathology, Apicoectomy/methods, Bisphenol A-Glycidyl Methacrylate/therapeutic use, Calcium Compounds/therapeutic use, Cohort Studies, Dentin-Bonding Agents/therapeutic use, Drug Combinations, Female, Follow-Up Studies, Humans, Longitudinal Studies, Male, Microsurgery/methods, Middle Aged, Oxides/therapeutic use, Periapical Periodontitis/surgery, Prognosis, Retrograde Obturation/methods, Root Canal Filling Materials/therapeutic use, Silicates/therapeutic use, Single-Blind Method, Tooth Cervix/pathology, Treatment Outcome, Wound Healing/physiology
Research areas
ID: 216254395