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Comparative Outcome Analysis of Endodontic Microsurgery for Through-and-Through Lesions Using Propensity Score
Kim Ukseong1, Park Hayeon1, Kim Sunil1
1Microscope Center, Department of Conservative Dentistry and Oral Science Research Center, Yonsei University College of Dentistry, Seoul, Republic of Korea.
Introduction:
Through-and-through (T-T) lesions present unique anatomical challenges in endodontic microsurgery (EMS), often resulting in delayed or incomplete healing. This study aimed to evaluate the clinical outcomes of EMS in T-T lesions, compare them with non-T-T lesions using propensity score matching.
Methods:
This retrospective case-control study reviewed 89 T-T teeth and 294 non-T-T teeth that underwent EMS in anterior regions, excluding those treated with bone grafts. Propensity score matching was performed at a 1:2 ratio (T-T: non-T-T), resulting in 89 T-T and 178 non-T-T matched teeth for cumulative outcome assessment with Kaplan-Meier analysis, and 75 T-T with 150 non-T-T, and 34 T-T with 68 non-T-T matched teeth for the 1- and 3-year evaluations of clinical and radiographic outcomes, respectively.
Results:
The 1-year success rate was 88.0% in the non-T-T group and 77.3% in the T-T group (P < .05). For 3-year outcomes, the success rates were 97.1% (non-T-T) and 88.2% (T-T), respectively. Lesion type significantly influenced the 1-year outcome, with T-T lesions associated with higher failure rates. No statistically significant difference was identified for 3-year outcomes. The cumulative survival analysis showed no significant differences between the groups.
Conclusions:
EMS appears to be a reliable treatment option for T-T lesions. Although short-term outcomes at 1 year were less favorable than those of the non-T-T lesions, these differences were no longer evident at 3 years. A follow-up period longer than 1 year may be necessary to accurately assess the healing dynamics of T-T lesions.
