Related Experiment Video
Updated: Jul 18, 2025
Guided Endodontics: Three-Dimensional Planning and Template-Aided Preparation of Endodontic Access Cavities
Published on: May 24, 2022
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.
Introduction:
The aim of this retrospective cohort study was to evaluate the clinical outcomes and identify the prognostic factors of endodontic microsurgery based on cone-beam computed tomographic (CBCT) scans.
Methods:
Patients who underwent endodontic microsurgery in teeth with asymptomatic apical periodontitis were included. The clinical outcomes were determined based on clinical and radiographic examinations after surgery 12-48 months. Radiographic healing was assessed on CBCT images by using the modified PENN 3-dimensional criteria and classified into 4 categories: complete, limited, uncertain, and unsatisfactory healing. Multivariate logistic regression was performed to detect outcome risk factors.
Results:
Of the 204 teeth in 173 invited patients, 148 teeth of 126 patients were examined at review. On CBCT images, 88 teeth (59.5%) showed complete healing, and 42 (28.4%) teeth showed limited healing. All these 130 teeth were asymptomatic and achieved a clinical success rate of 87.8%. Uncertain healing was observed in 9 teeth, one of which was symptomatic. The remaining 9 teeth were unsatisfactory healing on CBCT scans, including 6 teeth with clinical symptoms and 3 free. Lesion type and root-end filling quality were significant outcome predictors (P < .05). The risk of treatment failure for teeth with combined endodontic-periodontal lesions was 8.6 times higher than that for teeth with isolated endodontic lesions. Adequate root-end filling quality improved the probability of success by 5.3 times.
Conclusions:
Based on CBCT data, an adequate performed endodontic microsurgery could have predictable success in teeth without periodontal involvement.
