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Periapical resurgery versus periapical surgery: a 5-year longitudinal comparison
M M Gagliani1, F G M Gorni, L Strohmenger
1Clinica Odontoiatrica, D.M.C.O. San Paolo, School of Dentistry, University of Milan, Milan, Italy. massimo.gagliani@unimi.it
International Endodontic Journal
|May 7, 2005
Summary
Periradicular surgery is effective for treating persistent periapical lesions. While retreatment after previous surgery is a viable option, primary surgical approaches show better outcomes with lower post-treatment disease rates.
Area of Science:
- Endodontics
- Oral Surgery
- Dental Radiology
Background:
- Persistent periapical lesions often require endodontic intervention.
- Surgical management is an option for cases with unresolved periapical disease after conventional treatment.
- Previous apical surgery outcomes require comparison with primary surgical interventions.
Purpose of the Study:
- To compare the success rates of periradicular surgery in teeth with prior surgical treatment versus those undergoing surgery for the first time.
- To evaluate the long-term outcomes of periradicular surgery for persistent periapical lesions.
Main Methods:
- A 5-year follow-up study of 231 roots in 164 patients with unresolved periapical lesions.
- Two groups: Group AS (unsuccessful conventional root canal treatment) and Group RS (previous apical surgery).
- Surgical procedures used ultrasonic retrotips and zinc-oxide EBA reinforced filling; radiological assessment of healing.
Main Results:
- Overall healing rate after 5 years was 78%.
- Group AS (primary surgery) showed an 86% healing rate, with 6% post-treatment disease.
- Group RS (retreatment surgery) had a 59% healing rate, with 23% post-treatment disease. The difference was statistically significant (P=0.001).
Conclusions:
- Surgical retreatment of previously operated teeth is a valid alternative to extraction.
- Primary periradicular surgery demonstrates a significantly lower rate of post-treatment disease compared to surgical retreatment.