Soft and Hard Tissue Remodeling after Endodontic Microsurgery: A Cohort Study

Area of Science:

• Endodontics
• Oral Surgery
• Periodontology

Background:

• Endodontic microsurgery (EMS) outcomes are influenced by surgical techniques.
• Assessing soft tissue healing and bone remodeling is crucial for treatment success.

Purpose of the Study:

• To evaluate the impact of different incision types, with or without coronally repositioning flaps (CRF), on soft tissue healing and crestal bone remodeling following EMS.

Main Methods:

• Analysis of clinical and cone-beam computed tomography (CBCT) images from 47 patients (120 teeth).
• Qualitative assessment of gingival marginal level (GML), papillary height, and scar formation.
• Quantitative CBCT analysis of crestal bone level (CBL) changes pre- and post-surgery.

Main Results:

• Gingival recession was more common with intrasulcular or papilla-based incisions, particularly on mandibular molars.
• Flap design influenced scar formation, and CRF was the only technique achieving coronal root coverage.
• No significant changes in papillary height or crestal bone height were observed post-EMS.

Conclusions:

• Soft tissue healing after EMS is site- and flap design-dependent.
• CRF can enhance GML outcomes, while crestal bone dimensions show minimal changes.
• Flap selection is critical for optimizing soft tissue results in endodontic microsurgery.