Long-term Success and Survival of Endodontic Microsurgery

Huang, Shuyan; Chen, Nah-Nah; Yu, Victoria Soo Hoon; Lim, Haikel A.; Lui, Jeen-Nee

doi:10.1016/j.joen.2019.10.022

Cited by 36 publications

(62 citation statements)

References 39 publications

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“…Additionally, advanced microsurgical tools and techniques including microscopy, ultrasonics, and biocompatible root-end filling materials may have contributed to success. The overall 5-year survival rate was 83.5%, which is similar to that of a smaller recent study [ 20 ]. Potential survival rates were even higher if unrelated extractions were excluded.…”

Section: Discussionsupporting

confidence: 88%

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Prognostic Factors of Long-Term Outcomes in Endodontic Microsurgery: A Retrospective Cohort Study over Five Years

Yoo

Kim

Perinpanayagam

et al. 2020

JCM

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The aim of this study was to analyze the long-term outcomes of endodontic microsurgeries in a cohort and identify their association with prognostic factors. A cohort of endodontic microsurgeries followed up periodically with complete clinical and radiographic records for at least 5 years were reviewed retrospectively. Their survival and healing status and profile characteristics were analyzed by Pearson chi-square test and logistic regression (α = 0.05) to identify prognostic factors that influenced outcomes. Of 652 cases in the cohort, 225 (34.5%) were included. The mean follow-up period was 90.4 months (range, 60–168 months). The long-term success rate was 80.5%, and the 5-year survival rate was 83.5%. Logistic regression showed higher success in anteriors compared to molars (OR = 5.405, (95% CI, 1.663–17.571; p = 0.005)) and in teeth with crown restorations (OR = 10.232, (95% CI, 3.374–31.024; p < 0.001)). Conversely, lower success was found in teeth with periodontal disease (OR = 0.170, (95% CI, 0.032–0.900; p = 0.037)) and maxillary sinus involvement (OR = 0.187, (95% CI, 0.035–0.994; p = 0.049)). Endodontic microsurgery has a highly favorable long-term outcome. Tooth position, crown restoration, periodontal disease, and maxillary sinus involvement were identified as main prognostic factors.

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Section: Discussionsupporting

confidence: 88%

“…Younger patients may have better healing capacity and less periodontal disease [ 1 ], but long-term follow-ups reduced their significance. Previous studies have reported that age and sex did not significantly affect outcomes [ 9 , 20 , 21 , 27 , 28 ].…”

Section: Discussionmentioning

confidence: 99%

Prognostic Factors of Long-Term Outcomes in Endodontic Microsurgery: A Retrospective Cohort Study over Five Years

Yoo

Kim

Perinpanayagam

et al. 2020

JCM

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“…Furthermore, Von Arx et al [ 32 ] confirmed that cases rated as healed after 1-year remained so in 93.9% of cases, after 5 years, with higher predictive value for MTA group (96.7%) in comparison with the COMP group (90.7%). Nevertheless, the classification of uncertain healing at a short-term follow-up appears to be the least predictable of all at a long-term follow-up [ 36 , 54 ].…”

Section: Discussionmentioning

confidence: 99%

“…First, all included studies were mainly carried out by specialists in a Hospital or University environment [ 2 , 7 , 9 , 11 , 32 , 35 , 36 , 37 , 38 , 39 ], which can lead to an overestimation of the outcome when the procedure is performed under a private clinical setting. Since the outcome has been reported to be influenced by the operator [ 54 ], there is a need to develop multicenter, pragmatic studies to evaluate the outcome of EMS in distinct conditions, as what happens on a daily basis in clinical practice. Furthermore, some authors established some rigorous exclusion criteria, such as teeth with a probing depth ≥4 mm [ 39 ], teeth that did not undergo NSER, or teeth with traumatic injuries [ 9 ].…”

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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“…Numerous studies have been performed to evaluate the outcome and prognostic factors of RCT and EMS based on clinical and radiographic examinations (7)(8)(9)(10). However, reported outcomes have shown considerable differences, probably due to differences in the data composition, clinical procedures, and methodology (3).…”

Section: Introductionmentioning

confidence: 99%

Outcomes and prognostic factors of apical periodontitis by root canal treatment and endodontic microsurgery-a retrospective cohort study

Liu¹,

Xue²,

Wang³

et al. 2021

Ann Palliat Med

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Background: The aim of this study was to analyze the outcome and prognostic factors of root canal treatment (RCT) and endodontic microsurgery (EMS) in the treatment of apical periodontitis (AP), respectively, and to compare the outcome and prognostic factors between initial RCT and nonsurgical retreatment (re-RCT) for AP.Methods: Patients with AP were recruited from the Stomatology Department of Peking University Third Hospital from January 2016 to December 2019. Data were collected by medical records review. Univariate analysis of treatment outcome was performed for the total RCT group, initial RCT group, re-RCT group and EMS group, respectively. Multivariate logistic regression was performed for the three RCT groups, respectively, but not for the EMS group. Results:The overall success of treatment for AP was 73.8%. The success rate of RCT in 229 cases was 70.7%, while that of EMS in 34 cases was 94.1%. The failure of RCT was significantly higher for elderly patients [odds ratio (OR) =1.025, P=0.013], teeth with incomplete fracture (OR =7.082, P=0.013), teeth with a greater crown root ratio (OR =1.198, P=0.029), teeth treated by a general dentist (OR =2.16, P=0.042) and teeth with unqualified treatment (OR =2.841, P=0.002). Of the 166 teeth treated by initial RCT, the success was 68.1%. A greater crown root ratio (OR =1.333, P=0.004) was identified as a risk factor for treatment.Of the 63 teeth treated by re-RCT, the success was 77.8%. A lower success was observed in teeth with unqualified treatment (OR =5.291, P=0.018). With regard to EMS, the univariate analysis showed that none of the variables were significantly related to the outcome.Conclusions: For AP treated by RCT, age, incomplete tooth fracture, crown root ratio, doctor classification and unqualified treatment had a strong impact on determining outcome. For initial RCT, crown root ratio was a significant outcome predictor, while for re-RCT, unqualified treatment was a strong statistically significant factor. No significant difference was found between the success of initial RCT and re-RCT for AP.

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Long-term Success and Survival of Endodontic Microsurgery

Cited by 36 publications

References 39 publications

Prognostic Factors of Long-Term Outcomes in Endodontic Microsurgery: A Retrospective Cohort Study over Five Years

Prognostic Factors of Long-Term Outcomes in Endodontic Microsurgery: A Retrospective Cohort Study over Five Years

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

Outcomes and prognostic factors of apical periodontitis by root canal treatment and endodontic microsurgery-a retrospective cohort study

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