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A retrospective radiographic study of root-end surgery with amalgam and intermediate restorative material
Devorah Schwartz-Arad1, Noam Yarom, Joseph P Lustig
1Department of Oral and Maxillofacial Surgery, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel-Aviv University, Israel. dubish@post.tau.ac.il
Objective:
We sought to compare amalgam with intermediate restorative material in terms of their effectiveness as root-end filling materials during root-end surgeries.
Study Design:
A root-end operation was performed on 228 patients with 262 endodontically treated teeth with periapical lesions. Of these teeth, 122 from 101 patients were available for follow-up. Radiographs were taken immediately postoperatively and again at a mean of 11.25 months (range, 6-45 months) postoperatively. The radiographs were digitized, and the diameter of the periapical lesion was measured by means of a computerized system. The mesiodistal distance at the cementoenamel junction served as an internal standard. Radiographic findings were classified into 1 of 3 groups: complete healing, incomplete healing, or unsatisfactory (no) healing.
Results:
Complete healing was observed in 44.3% of the teeth, incomplete healing in 21.3%, and unsatisfactory healing in 34.4%. No statistical significance was found for amalgam versus intermediate restorative material, but teeth that underwent additional operations had a significantly worse success rate than those that underwent only first-time operations. No correlation was found between the subjective prognosis by the surgeons and the long-term outcome.
Conclusion:
As root-end filling materials, amalgam and intermediate restorative material had the same clinical effectiveness. The classic root-end operation is unpredictable. Reoperations should be reconsidered and avoided if possible.