Dentine‐bonded resin composite (Retroplast) for root‐end filling: a prospective clinical and radiographic study with a mean follow‐up period of 8 years

Abstract

The present long-term study indicates that RP can be used for root-end filling with a successful treatment outcome.

Five-Year Longitudinal Assessment of the Prognosis of Apical Microsurgery

“…In the absence of any other comparable long-term studies, our results suggested that, at best, the chance of teeth to heal in the longer-term after apical microsurgery using ProRoot MTA would be 86%, which is lower than the 94% suggested in the recent systematic review (6). This suggested prognosis is far better than that reported in previous 4-year or longer studies on apical surgery performed with other root-end filling materials and without emphasis on the microsurgical technique (8,9,11,12,13,23). Nevertheless, additional long-term, methodologically sound studies are required to augment the evidence for the prognosis after apical microsurgery using ProRoot MTA.…”

“…The reviewers suggest a 94% chance to cure post-treatment AP after endodontic microsurgery (6); however, this conclusion is supported exclusively by short-term (1 or 2 years) outcome reports. Considering the 5% to 25% risk of regression to AP reported beyond 3 or more years after apical surgery (7)(8)(9)(10)(11)(12), the short-term data supporting the current systematic review's conclusions (6) may overestimate the long-term prognosis of endodontic microsurgery (4). Similarly, the assessment of significant outcome predictors requires long-term observations as reported in only 4 studies (12)(13)(14)(15), none of which focused on endodontic microsurgery.…”

“…Similarly, the assessment of significant outcome predictors requires long-term observations as reported in only 4 studies (12)(13)(14)(15), none of which focused on endodontic microsurgery. By reviewing the contrasting results of these 4 studies and the recent reviews, the potential significant predictors of healing after apical surgery may be patient related (patient's age over 45 years), tooth related (the absence of preoperative signs and symptoms, adequate root filling density, inadequate root filling length, a small periapical lesion of #5 mm, and the absence of a post), and treatment related (use of the microsurgical technique) (5,(12)(13)(14)(15).…”

Reply to Dr Friedman

“…In a further three of the studies, incomplete healing ranged from 13% to 27% (5,12,21), which is considerably higher than the incidence suggested elsewhere (10,11,19,20). Why the concern?…”

“…The suggested healing reversal within 4 years after treatment, as mentioned in the letter to the editor, is based on 6 references. Five of these 6 citations (7)(8)(9)(10)(11) are not related to endodontic microsurgery and use materials such as composite resin, gutta-percha, or amalgam as filling materials. Zuolo et al (12) clearly demonstrated that for modern filling materials, as applicable in microsurgery, a healing peak with subsequent decline in successful outcome does not exist, but cases that were considered healed within 1 year stayed healed and even after 4 years did not reveal changes.…”