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Optimising Outcomes in Endodontic Microsurgery: Evidence, Uncertainties and Future Directions
1Department of Conservative Dentistry and Oral Science Research Center, Microscope Center, Yonsei University College of Dentistry, Seoul, Korea.
Endodontic microsurgery (EMS) outcomes depend on lesion type, with isolated lesions faring better. While regenerative procedures and guided surgery show promise, their effectiveness requires further study for optimal periapical lesion management.
Area of Science:
- Endodontics
- Oral Surgery
- Regenerative Medicine
Background:
- Endodontic microsurgery (EMS) is crucial for persistent periapical pathologies.
- Lesion type significantly impacts EMS success rates.
- Conventional retreatment is often infeasible or has failed.
Purpose of the Study:
- To review factors influencing endodontic microsurgery outcomes.
- To assess the role of lesion type, regenerative procedures, and guided surgery.
- To provide guidance for clinical decision-making in EMS.
Main Methods:
- Literature review of endodontic microsurgery studies.
- Analysis of factors affecting periapical lesion management.
- Evaluation of adjunctive regenerative and guided surgical techniques.
Main Results:
- Isolated endodontic lesions have favorable outcomes; combined or through-and-through lesions are challenging.
- Evidence for adjunctive regenerative procedures is inconclusive, needing further research.
- Guided surgical systems may enhance precision, especially in specific lesion types.
Conclusions:
- Lesion type is a key determinant of EMS prognosis.
- Critical assessment of adjunctive regenerative procedures and technologies is needed.
- EMS indications may expand with careful case selection and technique.
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