Prognostic factors on periapical surgery: A systematic review

Abstract

BackgroundAnalyze the most important prognostic factors when performing periapical surgery and compare the success rates of distinct authors.IntroductionPeriapical surgery is an approach to treat non-healing periapical lesions and it should be viewed as an extension of endodontic treatment and not as a separate entity.Material and MethodsA search of articles published in Cochrane, PubMed (MEDLINE) and Scopus was conducted with the key words “prognostic factors”, “prognosis”, “periapical surgery”, “endodontic surgery” and “surgical endodontic treatment”. The inclusion criteria were articles including at least 10 patients, published in English, for the last 10 years. The exclusion criteria were nonhuman studies and case reports.Results33 articles were selected from 321 initially found. Ten articles from 33 were excluded and finally the systematic review included 23 articles: 1 metaanalysis, 1 systematic review, 2 randomized clinical trials, 6 reviews, 12 prospective studies and 1 retrospective study. They were stratified according to their level of scientific evidence using the SORT criteria.ConclusionsFactors associated with a better outcome of periapical surgery are patients ≤45 years old, upper anterior or premolar teeth, ≤10 sized lesions, non cystic lesions, absence of preoperative signs and symptoms, lesions without periodontal involvement, teeth with an adequate root-filling length, MTA as root-end filling material, uniradicular teeth, absence of perforating lesions, apical resection < 3 mm, teeth not associated to an oroantral fistula and teeth with only one periapical surgery. Key words:Prognostic factors, prognosis, periapical surgery, endodontic surgery and surgical endodontic treatment.

Mineral trioxide aggregate and other bioactive endodontic cements: an updated overview – part II: other clinical applications and complications

“…, Serrano‐Giménez et al . ). Two systematic reviews and meta‐analyses reported that the type of root‐end filling material (MTA, IRM, SuperEBA) had no significant influence on treatment outcome (Tsesis et al .…”

Concentrated Growth Factors as an Ingenious Biomaterial in Regeneration of Bony Defects after Periapical Surgery: A Report of Two Cases

“…Calcium hydroxide medicament (RC Cal, Prime Dental Products, India) was placed thrice for a period of 1 week each. As the root canals exhibited persistent discharge of exudates and due to two prognostic factors (size of the lesion which was more than 10 mm and the thinning or destruction of the palatal bone) which were unfavourable for this case [9], periapical surgery was planned following the recommendation given by the Spanish Society of Oral Surgery (point 3: a radiotransparent lesion measuring over 8 to 10 mm in diameter).…”

Periapical Microsurgery with an Endoscope and Microscope of Two Upper Central Incisors Already Subjected to Periapical Surgery 25 Years Ago

“…Three such studies involving very low risk of bias [ 15 – 17 ] have reported success rates of 85-94.3% with the use of MTA. A meta-analysis published by Von Arx et al [ 18 ] and a systematic review by Serrano-Giménez et al [ 19 ] have defined MTA as the material of choice for retrograde cavity sealing in periapical surgery.…”