Comparison of Endodontic Failures between Nonsurgical Retreatment and Endodontic Surgery: Systematic Review and Meta-Analysis with Trial Sequential Analysis

Dioguardi, Mario; Stellacci, Camilla; Femina, Lucia La; Spirito, Francesca; Sovereto, Diego; Laneve, Enrica; Manfredonia, Massimo Francesco; D’Alessandro, Alfonso; Ballini, Andrea; Cantore, Stefania; Muzio, Lorenzo Lo; Troiano, Giuseppe

doi:10.3390/medicina58070894

Cited by 22 publications

(19 citation statements)

References 44 publications

(75 reference statements)

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“…Our finding of better outcome after microsurgery compared with non‐surgical retreatment is consistent with other reports (Bucchi et al, 2022; Dioguardi et al, 2022; Torabinejad et al, 2009), including tooth survival studies (Haxhia et al, 2021). Some studies have described faster healing after the surgical procedure compared with non‐surgical retreatment after 1 year, but a regression of successful cases for endodontic surgery over a follow‐up period of 4 years (Del Fabbro et al, 2007; Kvist & Reit, 1999).…”

Section: Discussionsupporting

confidence: 92%

Treatment outcome of surgical and non‐surgical endodontic retreatment of teeth with apical periodontitis

2023

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Aims To evaluate and compare the treatment outcome of root filled teeth with apical periodontitis treated either non‐surgically or by endodontic microsurgery, and to assess the influence of an intra‐radicular post, clinical and demographic factors. Methodology Clinical and radiological data from 1157 patients with apical periodontitis in previously root filled teeth treated by postgraduate students at the Department of Endodontics, University of Oslo, between September 2010 and January 2020 with recall data at least 11 months from completion were studied. Surgical cases were scored using the Rud/Molven criteria and grouped into success, uncertain or failure at control. Non‐surgical cases were scored with the periapical index (PAI) and similarly grouped into success, uncertain or failure at control. Chi‐square analyses were used for comparison of subgroups of teeth treated and logistic regression analyses for assessment of the influence of clinical variables. Results Non‐surgical retreatment was performed on 351 teeth and 107 teeth were treated with endodontic microsurgery, with overall success rates of 65.5% and 77.6%, respectively. The difference was statistically significant. Teeth with an intra‐radicular post treated non‐surgically (n = 30) were successful in 73.3% of cases, whereas teeth with intra‐radicular post treated with endodontic microsurgery (n = 30) had a lower, 66.7% success rate. The distribution of tooth groups (anterior, premolar and molar) differed significantly between surgical and non‐surgical cases, with maxillary anterior and premolar teeth more often treated surgically. Non‐surgical retreatment cases were significantly influenced by patients' age (older patients had poorer outcome) and pre‐operative PAI score (negatively correlated with outcome). Surgical cases were not significantly influenced by the factors studied here. Conclusions The tooth type differed significantly for teeth treated by surgical versus non‐surgical methods. Microsurgical treatment with apicectomy and retrograde filling showed significantly better treatment results than non‐surgical retreatment of teeth with apical periodontitis, whereas treatment outcome in teeth with posts after non‐surgical treatment tended to be better than after surgical treatment. Outcome of non‐surgical retreatment was negatively influenced by older age and higher pre‐operative PAI score.

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Section: Discussionsupporting

confidence: 92%

Treatment outcome of surgical and non‐surgical endodontic retreatment of teeth with apical periodontitis

2023

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“…Data results from meta-analyses report an aggregate risk ratio (RR) between nonsurgical endodontic retreatment and surgical endodontic retreatment of: 1.05 [0.74, 1.47] at one-year follow-up; RR 2.22 [1.45, 3.41] at two years of followup; an RR 1.08 [0.73 1.62] for a follow-up period of 3-4 years; and an RR 0.92 [0.53, 1.61] for a follow-up period of 8 to 10 years. The results of the present meta-analysis showed that, in the long term, the risk of failure is identical for both groups, with only a slightly higher risk of failure for non-surgical endodontic retreatments, when only two years of follow-up are considered [3].…”

Section: Resultsmentioning

confidence: 56%

“…In the presence of persistent endodontic lesions or endodontic failure, the alternative for the recovery of the dental element is endodontic retreatment or endodontic surgery, which consists of surgical removal of the root apices with retrograde closure of the endodontic [3].…”

Section: Introductionmentioning

confidence: 99%

“…Endodontic retraction is a procedure performed on a tooth that has received a previous attempt at a definitive treatment that has resulted in a condition that requires further additional endodontic treatment to obtain a successful result [1,2]. The major cause of treatment failure is insufficient cleaning and inadequate filling, according to Abou-Rass, 1982 [3]. The endodontic failure is due to the lack of a technicalscientific-biological basis.…”

Section: Introductionmentioning

confidence: 99%

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Endodontic treatment and retreatment: a large systematic review

Alcalde¹,

Paula²,

Paula³

et al. 2022

MedNEXT

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Introduction: In the context of treatment endodontics, endodontic surgery encompasses various procedures for the treatment of teeth with a history of endodontic treatment failures, such as apical surgery, crown and root resections, surgical repair of perforations, and intentional replantation. Endodontic microsurgery is the evolution of traditional apicectomy techniques and incorporates high magnification, ultrasonic preparation of the root end, and filling of the root end with biocompatible materials. Objective: It was to carry out a vast literature review in a systematic way to show the main considerations of endodontic treatment and retreatment. Methods: The systematic review rules of the PRISMA Platform were followed. The research was carried out from September to November 2022 in Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 120 articles were found, and 75 articles were evaluated and 35 were included in this systematic review. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 20 studies with a high risk of bias and 13 studies that did not meet GRADE. Most studies showed homogeneity in their results, with I2 =96.2% >50%. Modern endodontic surgery uses the dental operating microscope and cone beam computed tomography for preoperative diagnosis and treatment planning. In the presence of persistent endodontic lesions or endodontic failure, endodontic treatment or endodontic surgery is required. In the long term, the risk of failure is identical for both groups, with only a slightly higher risk of failure for non-surgical endodontic retreatments when only two years of follow-up are considered.

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“…Root canal retreatment is a common procedure used to treat teeth that have failed previous root canal treatment. [17]. The goal of retreatment is to remove the old lling material, disinfect the root canals, and then ll them with a new material [ 30].…”

Section: Introductionmentioning

confidence: 99%

Apical transportation induced by reciprocating files in removal of GuttaCore and single- cone from curved root canals: A micro-CT analysis

Hassan

Ibrahim

2023

Preprint

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Objectives: Endodontic instruments tend to diverge from the long axis of root canal during preparation. This tendency increases with increasing canal curvature and retreatment cases. The purpose of this study was to assess and compare the apical transportation induced by different reciprocating single file systems in curved canals obturated with GuttaCore and single-cone obturation techniques using microcomputed tomography. Materials and methods: Sixty-four mandibular molar teeth with root canal systems that have two independent severely curved canals in the mesial root have been chosen for the current study. The root canals have been instrumented with WaveOne Gold primary file and obturated by Single-cone and GuttaCore obturation techniques. First micro-CT scan has been taken and the samples have been subdivided into 4 groups for each obturation technique (n=16 canals each group) according to the retreatment system: Group R: Reciproc (R25 file), group RB: Reciproc Blue (R25 file), group WO: WaveOne (Primary file 25) and group WOG: WaveOne Gold (Primary file 25). After the retreatment procedures, the second micro-CT scan has been taken and then the apical transportation at 2, 3 and 4 mm from the apex were calculated. Results: Apical transportation caused by Reciproc and WaveOne groups was significantly higher than the Reciproc Blue and WaveOne Gold groups. Conclusion: Under the circumstances of the current study, Reciproc and WaveOne files caused higher apical transportation than the Reciporc Blue and WaveOne Gold files. The lowest apical transportation occurred at 2 mm from the apex. Clinically relevant: The use of Reciproc blue and WaveOne Gold files can be considered safer in the removal of GuttaCore and single-cone obturation materials

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Comparison of Endodontic Failures between Nonsurgical Retreatment and Endodontic Surgery: Systematic Review and Meta-Analysis with Trial Sequential Analysis

Cited by 22 publications

References 44 publications

Treatment outcome of surgical and non‐surgical endodontic retreatment of teeth with apical periodontitis

Treatment outcome of surgical and non‐surgical endodontic retreatment of teeth with apical periodontitis

Endodontic treatment and retreatment: a large systematic review

Apical transportation induced by reciprocating files in removal of GuttaCore and single- cone from curved root canals: A micro-CT analysis

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