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Reasons for apicectomies. A retrospective study

J M el-Swiah¹, R T Walker

¹Leeds Dental Institute/Division of Restorative Dentistry, UK.

Endodontics & Dental Traumatology

|August 1, 1996

Summary

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This study found that combined biological and technical factors most often lead to apicectomy. High-quality root canal treatment is crucial to prevent the need for this surgical procedure.

Area of Science:

Endodontics
Oral Surgery

Background:

Apical periodontitis often requires endodontic retreatment or apical surgery.
Factors influencing the decision for apicectomy require detailed evaluation.

Purpose of the Study:

To analyze clinical factors guiding the decision to perform apicectomies.
To identify the prevalence of biological versus technical factors in apicectomy decisions.

Main Methods:

Retrospective analysis of 517 apicectomies in 392 patients (1990-1992).
Data collected included referral source, root canal filling quality, lesion size, restoration type, and influencing factors.
Factors were categorized as biological, technical, or combined.

Main Results:

Combined biological and technical factors were the most common indication for apicectomy (60% biological, 40% technical).

Related Experiment Videos

Primary biological factors: persistent symptoms (54%) and periradicular lesions (44%).

Primary technical factors: post crowns (60%) and crowned teeth without posts (31%).

Conclusions:

The decision for apicectomy is predominantly driven by a combination of biological and technical issues.
Emphasizes the importance of high-standard conventional root canal treatment to minimize the need for surgical intervention.