Abstract
BackgroundPeriapical surgery is now a reliable therapeutic procedure for the treatment of teeth with periapical lesions, particularly when orthograde retreatment is problematic. However, little information is available regarding treatment planning of cases referred for periapical surgery. Therefore, this study was conducted to analyze and evaluate the factors that affect the decision-making process for periapical surgery.Material and MethodsThis study retrospectively assessed clinical and radiographic data from patients undergoing periapical surgery. The factors involved in deciding to perform periapical surgery were classified into technical, biological, and combined factors.ResultsOut of 821 patients, 544 (66.3%) underwent endodontic treatment/retreatment, 204 (24.8%) were treated with coronal restorations and 60 (7.3%) were treated with post. Periapical surgery was indicated for biological reasons in 35% of patients and for technical reasons in 17.9%. The common biological factor was persistent clinical symptoms (19.7%). The most common technical cause was failure of previous endodontic treatment (66.3%). Nearly half of all periapical lesions (45%) were <5 mm in size. Periapical surgery was justified in only 434 (52.9%) subjects.ConclusionsWe suggest that it is very important for patients to be informed and encouraged about endodontic retreatment in order to reduce unnecessary surgical procedures. Key words:Periapical surgery, case selection, treatment planning.
Highlights
Persistent apical periodontitis following orthograde root-canal treatment is common among adult populations in various countries, with prevalence rates varying between 27%-70% and increasing with age [1]
Patient anamneses showed all patients to have Class I or Class II physical status according to American Society of Anesthesiology (ASA) criteria [19]
The most common technical cause was failure of previous endodontic treatment/retreatment (66.3%) (Tables 1-3). 79.9 % of coronal restorations were adequate and 71.7 % of posts were longer than 5 mm
Summary
Persistent apical periodontitis following orthograde root-canal treatment is common among adult populations in various countries, with prevalence rates varying between 27%-70% and increasing with age [1]. Periapical surgery is a reliable therapeutic procedure for the treatment of teeth with periapical lesions, when orthograde retreatment is problematic. Material and Methods: This study retrospectively assessed clinical and radiographic data from patients undergoing periapical surgery. Results: Out of 821 patients, 544 (66.3%) underwent endodontic treatment/retreatment, 204 (24.8%) were treated with coronal restorations and 60 (7.3%) were treated with post. Periapical surgery was indicated for biological reasons in 35% of patients and for technical reasons in 17.9%. Conclusions: We suggest that it is very important for patients to be informed and encouraged about endodontic retreatment in order to reduce unnecessary surgical procedures
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