Influence of Size and Volume of Periapical Lesions on the Outcome of Endodontic Microsurgery: 3-Dimensional Analysis Using Cone-beam Computed Tomography

Kim, Dohyun; Ku, Hyeonkyeong; Nam, Taekjin; Yoon, Tai Cheol; Lee, Chan Young; Kim, Euiseong

doi:10.1016/j.joen.2016.05.006

Cited by 45 publications

(54 citation statements)

References 38 publications

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“…Second, it was challenging to make an objective data interpretation due to the lack of criteria consistency among the studies; there is a need to establish guidelines to report outcomes targeted to studies on EMS. Lastly, despite the current trend of the search for comparative outcome results between 2-Dimensional (2D) and 3-Dimensional (3D) outcome measurement, the inclusion of such studies [ 55 , 56 , 57 ] was not possible due to a short follow-up time [ 57 ], a retrospective study design [ 56 ], or to the clinical and radiographic criteria applied [ 55 ]. Although there are studies reporting that 2D evaluation overestimates healing compared with 3D [ 23 , 55 ], Kruse et al [ 18 ] developed a study with the aim to make a comparison of the diagnostic validity between 2D and 3D outcome measurement to determine the true nature of periapical lesions diagnosed through these two different radiographic methods.…”

Section: Discussionmentioning

confidence: 99%

Long-Term Prognosis of Endodontic Microsurgery—A Systematic Review and Meta-Analysis

et al. 2020

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Background and objectives: The long-term outcome of endodontic microsurgery (EMS) performed on root-filled teeth affected by post-treatment apical periodontitis (AP) has been a matter of debate, re-launched by the introduction of novel root-end filling materials which have been proven to improve the short-term outcome of EMS. The purpose of this systematic review and meta-analysis is to evaluate the clinical and radiographic long-term outcome of endodontic microsurgery in teeth diagnosed with secondary AP through radiographic evaluation. Materials and Methods: This systematic review and meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Inclusion and exclusion criteria were defined a priori to select the best longitudinal evidence. Only randomized clinical trials (RCT) and prospective clinical studies (PCS), with a follow-up ≥ 2-year, and exhibiting well-established clinical and radiographic outcome criteria, were selected. Results: A total of 573 articles were obtained, from which 10 fulfill inclusion criteria: 6 PCS and 4 RCT. Meta-analysis showed a pooled proportion of success rate of 91.3%, from an overall amount of 453 treated teeth included in RCT; from overall 839 included teeth in PCS, a pooled success rate of 78.4% was observed, with the follow-up time ranging from 2 to 13-years. Survival rate outcomes varied from 79 to 100% for the same follow-up period. Five prognostic factors with influence on the outcome were disclosed: smoking habits, tooth location and type, absence/presence of dentinal defects, interproximal bone level, and root-end filling material. Conclusions: High success rates and predictable results can be expected when EMS is performed by trained endodontists, allowing good prognosis and preservation of teeth affected by secondary AP.

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Section: Discussionmentioning

confidence: 99%

Long-Term Prognosis of Endodontic Microsurgery—A Systematic Review and Meta-Analysis

et al. 2020

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“…The demographic and baseline clinical characteristics of the study population are given in Table 1. Lesion sizes - to give an approximation of the severity of the periapical process - were calculated as recommended by Kim et al [19]: the mesiodistal (width), buccolingual (depth) and apicocoronal (height) dimensions were measured. All patients were referred for endodontic surgery by general dental practitioners to the Department of Operative and Esthetic Dentistry, Faculty of Dentistry, University of Szeged (Szeged, Hungary).…”

Section: Methodsmentioning

confidence: 99%

Accuracy and clinical safety of guided root end resection with a trephine: a case series

Antal

Nagy

Braunitzer³

et al. 2019

Head Face Med

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BackgroundRoot-end resection is an endodontic surgical intervention that requires high precision so that all ramifications and lateral canals so as infected tissues are eliminated. An exploratory study was conducted to justify the clinical safety and accuracy of guided root-end resection with a trephine.MethodsFourteen root-end resections were performed in 11 patients. With the aid of computer tomography and rapid prototyping a stereolithographically fabricated, tooth-supported surgical template was used to guide trephinations. Surgery was performed using the printed surgical stent and a trephine was used not only for the osteotomy but for the root end resection as well.ResultsThe root end was successfully and completely resected by the trephine in all cases. No intraoperative complications were observed in any of the cases, and the patients were free of symptoms indicating recurrence or complications at the 6-month follow-up. The median angular deviation of the trephination was 3.95° (95% CI: 2.1–5.9), comparable to the angular deviation of guided implant surgery. The mean apex removal error (ARE) was 0.19 mm (95% CI: 0.03–0.07). The mean osteotomy depth error (ODE) was 0.37 mm (95% CI: 0.15–1.35). Overpenetration was a characteristic finding, which indicates the necessity of a stop-trephine.ConclusionsWithin the limitations of this study, we conclude that our results support the use of guided trephination for root-end resection.

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“…The titles and abstracts of the 113 selected articles were screened and 79 articles were excluded. Then, the remaining 34 articles were subjected to full-text analysis to assess eligibility, with 21 articles being excluded [ 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 ] according to the reasons listed in Table S2 . Therefore, 13 articles were included in the qualitative assessment: one randomized controlled trial [ 8 ], four prospective cohort studies [ 13 , 14 , 15 , 51 ], and eight retrospective cohort studies [ 9 , 10 , 11 , 17 , 26 , 52 , 53 , 54 ].…”

Section: Resultsmentioning

confidence: 99%

Impact of Periodontal Attachment Loss on the Outcome of Endodontic Microsurgery: A Systematic Review and Meta-Analysis

et al. 2021

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Background and Objectives: Endodontic microsurgery (EMS) aims to eradicate the sources of infection once the apical root resection removes most of the infected anatomical structures and repairs potential procedural errors in the apical region. An endodontic-periodontal lesion yields a pathological communication between the pulp and the periodontium. The purpose of this systematic review and meta-analysis is to evaluate the impact of periodontal attachment loss on the outcome of teeth submitted to EMS. Materials and Methods: PRISMA guidelines were followed. An electronic search was performed in EBSCOhost, Embase and PubMed databases with the following search key: (“endodontic microsurgery” AND “outcome”). No filters were used concerning the year of publication or language. Only randomized clinical trials, prospective and retrospective clinical studies in humans, with a minimum one-year follow-up, defined clinical and radiographic outcome criteria and estimable success rate for endodontic-periodontal lesion were included. Statistical analysis was performed using OpenMeta[Analyst] software. Results: Of a total of 113 articles, 34 were selected for full-text reading after duplicates deletion and title and abstract analysis. Thirteen and six studies were included in the systematic review and meta-analysis, respectively. A total of 2775 pooled teeth were submitted to EMS, of which 492 teeth and 4 roots had periodontal involvement. According to the qualitative analysis, success rates of the endodontic-periodontal group ranged from 67.6% to 88.2%. Meta-analysis revealed that the absence of periodontal attachment loss was predictive of a higher likelihood of success with an odds ratio of 3.14. Conclusions: Periodontal attachment loss presents a risk factor for EMS outcome. Although endodontic-periodontal lesions were associated with lower success rates considering a 1 to 10 years follow-up period, long-term successful prognosis following EMS has been reported, therefore presenting a fully valid and viable therapeutic option for the management of this type of lesions.

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Influence of Size and Volume of Periapical Lesions on the Outcome of Endodontic Microsurgery: 3-Dimensional Analysis Using Cone-beam Computed Tomography

Cited by 45 publications

References 38 publications

Long-Term Prognosis of Endodontic Microsurgery—A Systematic Review and Meta-Analysis

Long-Term Prognosis of Endodontic Microsurgery—A Systematic Review and Meta-Analysis

Accuracy and clinical safety of guided root end resection with a trephine: a case series

Impact of Periodontal Attachment Loss on the Outcome of Endodontic Microsurgery: A Systematic Review and Meta-Analysis

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