Treatment Outcome in Endodontics—The Toronto Study. Phases I and II: Apical Surgery

Wang, Nancy; Knight, Keith; Dao, Thuan; Friedman, Shimon

doi:10.1097/01.don.0000137633.30679.74

Cited by 122 publications

(186 citation statements)

References 32 publications

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“…The size of the apical lesion might also have a deleterious effect on outcomes for endodontic surgery, with larger lesions being related to less favorable healing. Among the surgical articles that stratified outcome data related to lesion size, a 5%-21% decrease in success was reported for teeth with greater than 5-mm-diameter lesions preoperatively, compared with those with lesions less than 5 mm in diameter (40,45,49,61,62). Although some individual articles reported significant differences relating to tooth type, tooth location (maxillary versus mandibular), and patient age, we did not observe clear patterns comparing the data from all the articles.…”

Section: Discussioncontrasting

confidence: 56%

“…Reported success rates were 5%-27% lower for re-surgery compared with first-time surgery (56,(62)(63)(64)(65) according to most articles, with 1 article reporting 11% greater success for reoperated cases (66). A systematic review of re-surgery published in 2001 by Peterson and Gutmann (67) reported a failure rate of 38% for re-surgery, although no comparison was made to first-time surgery.…”

Section: Discussionmentioning

confidence: 99%

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Outcomes of Nonsurgical Retreatment and Endodontic Surgery: A Systematic Review

Torabinejad

Corr

Handysides

et al. 2009

Journal of Endodontics

362

210

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Introduction: The purpose of this systematic review was to compare the clinical and radiographic outcomes of nonsurgical retreatment with those of endodontic surgery to determine which modality offers more favorable outcomes. Methods: The study began with targeted electronic searches of MEDLINE, PubMed, and Cochrane databases, followed with exhaustive hand searching and citation mining for all articles reporting clinical and/or radiographic outcomes for at least a mean follow-up of 2 years for these procedures. Pooled and weighted success rates were determined from a meta-analysis of the data abstracted from the articles. Results: A significantly higher success rate was found for endodontic surgery at 2-4 years (77.8%) compared with nonsurgical retreatment for the same follow-up period (70.9%; P < .05). At 4-6 years, however, this relationship was reversed, with nonsurgical retreatment showing a higher success rate of 83.0% compared with 71.8% for endodontic surgery (P < .05). Insufficient numbers of articles were available to make comparisons after 6 years of follow-up period. Endodontic surgery studies showed a statistically significant decrease in success with each increasing follow-up interval (P < .05). The weighted success for 2-4 years was 77.8%, which declined at 4-6 years to 71.8% and further declined at 6+ years to 62.9% (P < .05). Conversely, the nonsurgical retreatment success rates demonstrated a statistically significant increase in weighted success from 2-4 years (70.9%) to 4-6 years (83.0%; P < .05). Conclusions: On the basis of these results it appears that endodontic surgery offers more favorable initial success, but nonsurgical retreatment offers a more favorable long-term outcome. (J Endod 2009;35:930-937)

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Section: Discussioncontrasting

confidence: 56%

Section: Discussionmentioning

confidence: 99%

Outcomes of Nonsurgical Retreatment and Endodontic Surgery: A Systematic Review

Torabinejad

Corr

Handysides

et al. 2009

Journal of Endodontics

362

210

View full text Add to dashboard Cite

show abstract

“…With respect to apical surgeries, apicoectomies have a success rate of 74% and a survival rate of 91% (Wang et al, 2004). A systematic review reported that the success rate of endodontic surgery (64.2%) was significantly greater than the resurgery percentage of success (35.7%) (Peterson & Gutmann, 2001).…”

Section: Survival Ratesmentioning

confidence: 99%

An Important Dilemma in Treatment Planning: Implant or Endodontic Therapy?

Çobankara¹,

Bellí²

2011

Implant Dentistry - A Rapidly Evolving Practice

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“…In case of anterior teeth for which the endodontic treatment was deemed satisfactory clinically (probing) and radiologically (Type A or C), the apex was simply burnished using a ball burnisher (Wallis R ) [20,27,28]. Indirect vision was achieved with surgical micro-mirrors.…”

Section: Standardized Surgical Protocolmentioning

confidence: 99%

Success rate and recurrence frequency of periapical surgery: prospective study on 132 cases

Alantar

Bloud²,

Galéazzi

et al. 2010

Med Buccale Chir Buccale

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-Objectives:Primary aim is to quantify the success rate of periapical surgery. Secondary objectives include the determination of the histological nature of the lesions, and the incidence of the different teeth on which this surgery is performed. Study design: This is a prospective cohort study conducted in one centre. The same operator following a standardized surgical protocol performed all surgeries. Follow-up (including clinical examination and periapical X-ray) was conducted at day 7, and months 6, 12 and 18. Statistical analysis included determination of the mean, standard deviation and paired two-tailed Student's t-test, for each of the variables. Results: 132 periapical surgeries were performed on 114 patients. Success and failure rate at 18 months, are 90%, and 6%, and uncertain in 4%. Histopathology confirmed that 72% of the lesions were granulomas, and 28% cysts. Periapical surgery pertains mostly to maxillary (70%) and posterior teeth (70%). Conclusion: Prognosis of conventional periapical surgery is very good. Failure rate peaks at 7 months, written informed consent is paramount.A radiolucent apex after endodontic treatment is a common finding with up to 45% of the treated teeth in certain studies [1,2]. These lesions can be found during a routine check-up, or during an emergency appointment when associated with pain. As orofacial pain is ascribed to periapical abscesses in 25% of the patients [3], these periapical radiolucencies, in the context of periapical surgery, can be a diagnostic challenge. Periapical abscesses are the consequence of a bacterial infection of the root canals [4]. Treatment classically consists of the elimination of necrotic and infected tissue, followed by obturation of the root canal system and a sealed restoration of the crown. Periapical surgery is indicated when root canal retreatment has failed or is contraindicated [4]. An osteo-mucoperiosteal flap followed by the appropriate osteotomy allows access to the apex of the tooth. The lesion is removed and the root canal system sealed [4]. Success rates reported vary between 40% [5] and 97% [6]. Correspondence: alpalantar@wanadoo.fr The main objective of this study is to assess the success rate of periapical surgery using a standardized protocol. Secondary objectives include the determination of the histological appearance of the lesions (granulomas or cysts), the incidence of the different teeth on which this surgery is performed, and the recurrence frequency.

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Treatment Outcome in Endodontics—The Toronto Study. Phases I and II: Apical Surgery

Cited by 122 publications

References 32 publications

Outcomes of Nonsurgical Retreatment and Endodontic Surgery: A Systematic Review

Outcomes of Nonsurgical Retreatment and Endodontic Surgery: A Systematic Review

An Important Dilemma in Treatment Planning: Implant or Endodontic Therapy?

Success rate and recurrence frequency of periapical surgery: prospective study on 132 cases

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