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The resection angle in apical surgery: a CBCT assessment.

Thomas von Arx1, Simone F M Janner2, Simon S Jensen2,3

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The resection angle in apical surgery varies significantly between tooth types, with maxillary anterior teeth having the largest angle. However, this angle does not significantly impact the success of apical surgery.

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Area of Science:

  • Dentistry
  • Oral Surgery
  • Radiology

Background:

  • Apical surgery aims to treat persistent periapical lesions.
  • The resection angle, or bevel, is a surgical parameter that may influence outcomes.
  • Understanding variations in resection angles is crucial for optimizing surgical techniques.

Purpose of the Study:

  • To analyze the resection angle in apical surgery.
  • To investigate the correlation between resection angle and treatment outcomes.
  • To examine the relationship between resection angle, tooth type, surgical depth, and root-end filling level.

Main Methods:

  • A prospective clinical study involving cone beam computed tomography (CBCT).
  • CBCT scans were taken pre- and post-operatively (1 year) for 62 roots in 55 teeth.
  • Measurements included resection angle, surgical depth, and root-end filling level, with teeth categorized by type and location.

Main Results:

  • The mean resection angle was 17.7° ± 11.4°, with maxillary anterior teeth showing the highest mean angle (25.8° ± 10.3°).
  • Significant differences in resection angles were found between maxillary anterior, maxillary posterior, and mandibular posterior teeth.
  • A trend suggested higher healing rates with shallower resection angles (≤20°), though not statistically significant. No correlation was found between angle and surgical depth or filling length.

Conclusions:

  • Significant differences exist in apical surgery resection angles across different tooth groups.
  • The resection angle in maxillary anterior teeth is notably larger than in other teeth.
  • Despite observed differences, the resection angle did not significantly affect the overall treatment outcome in this study.