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Clinical Outcome and Predictors of Endodontic Microsurgery Using Cone-beam Computed Tomography: A Retrospective
Ming-Ming Zhang1, Gao-Feng Fang1, Zu-Hua Wang1
1Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, China.
Endodontic microsurgery shows predictable success, especially in teeth without periodontal issues. Factors like lesion type and root-end filling quality significantly impact outcomes, with adequate fillings improving success rates.
Area of Science:
- Endodontology
- Oral Surgery
- Radiology
Background:
- Endodontic microsurgery is a key treatment for apical periodontitis.
- Cone-beam computed tomography (CBCT) offers advanced imaging for evaluating surgical outcomes.
- Identifying prognostic factors is crucial for optimizing treatment success.
Purpose of the Study:
- To assess clinical outcomes of endodontic microsurgery using CBCT.
- To identify prognostic factors influencing the success of endodontic microsurgery.
Main Methods:
- Retrospective cohort study of patients undergoing endodontic microsurgery.
- Clinical and radiographic evaluations at 12-48 months post-surgery.
- CBCT imaging with modified PENN 3D criteria for assessing radiographic healing.
Main Results:
- 87.8% clinical success rate in 148 evaluated teeth (126 patients).
- 59.5% complete healing and 28.4% limited healing observed on CBCT.
- Lesion type and root-end filling quality were significant predictors; combined endo-perio lesions increased failure risk 8.6x, adequate filling improved success 5.3x.
Conclusions:
- Endodontic microsurgery demonstrates predictable success in teeth without periodontal involvement.
- Adequate root-end filling quality is vital for successful outcomes.
- CBCT is an effective tool for evaluating healing after endodontic microsurgery.
