The Buffalo study: Outcome and associated predictors in endodontic microsurgery- a cohort study.

Area of Science:

• Endodontics
• Oral Surgery
• Radiology

Background:

• Endodontic microsurgery (EMS) is a specialized procedure for complex endodontic cases.
• Evaluating the outcomes and prognostic factors of EMS is crucial for optimizing treatment.
• Radiographic assessment methods, including periapical radiographs (PAs) and cone-beam computed tomography (CBCT), play a key role in outcome evaluation.

Purpose of the Study:

• To compare the outcomes of EMS assessed by PAs versus CBCT.
• To identify prognostic factors influencing the success of EMS.
• To determine the effect of guided tissue regeneration (GTR) on apical bone remodelling patterns.

Main Methods:

• Eighty-two patients (101 teeth) undergoing EMS were evaluated using clinical and radiographic (PA and CBCT) follow-ups.
• Two calibrated endodontists assessed radiographic healing, success, and survival rates.
• Statistical analyses, including regression, were used to identify prognostic factors and the impact of GTR.

Main Results:

• High survival (93%) and success rates (88% PA, 86% CBCT) were observed.
• CBCT demonstrated better inter-observer agreement than PAs for radiographic assessment.
• Major procedural errors were the sole negative predictor of EMS outcome; GTR affected bone remodelling patterns but not success rates.

Conclusions:

• EMS demonstrates high success and survival rates.
• Major procedural errors are critical factors affecting EMS outcomes.
• While GTR does not enhance success rates, it influences the quality of apical bone remodelling post-EMS.