Retrospective follow-up assessment of prognostic variables associated with the outcome of periradicular surgery
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P A Villa-Machado1, X Botero-Ramírez, S I Tobón-Arroyave
1POPCAD Research Group, Laboratory of Immunodetection and Bioanalysis, Faculty of Dentistry, University of Antioquia, Medellín, Colombia.
Aim:
To investigate, retrospectively over a 1- to 16-year follow-up period, the strength and independence of the association of different patient-, tooth- and surgery-related prognostic variables with the outcome of periradicular surgery.
Methodology:
The study cohort included 171 teeth in 154 subjects. Clinical and radiographic measures along with the follow-up period were used to determine the healing outcome. For statistical analysis, results were dichotomized into healed/healing versus asymptomatic function/persistent disease cases. The association between candidate prognostic variables and asymptomatic function/persistent disease was analysed individually and adjusted for confounding using a multivariate binary logistic regression model.
Results:
The percentage of success (healed/healing cases) was found to be 83.6%, whereas the percentage of failure (asymptomatic function/persistent disease cases) was found to be 16.4%. Whilst univariate analysis revealed a positive association of the presence of preoperative signs/symptoms, unsatisfactory quality of the coronal restoration, pronounced root-end resection bevel and inadequate quality of root-end filling with asymptomatic function/persistent disease, after multivariate binary logistic regression analysis only the unsatisfactory quality of the coronal restoration and inadequate quality of root-end filling were strongly and independently associated with disease status. Confounding and interaction effects between candidate prognostic variables was noted.
Conclusions:
The findings of this study suggest that whilst the quality of both the coronal restoration and the root-end filling might be the foremost prognostic variables in periradicular surgery, there are synergistic biological interactive and mutually confounding effects with respect to root-end resection bevel and preoperative signs and/or symptoms that may be also associated with an increased proportion of failures after periradicular surgery.