Skip to main content
Log in

Success rate 1 year after apical surgery: a retrospective analysis

  • Original Article
  • Published:
Oral and Maxillofacial Surgery Aims and scope Submit manuscript

Abstract

Purpose

The aim of the current study was the retrospective analysis of the outcomes of teeth treated with apical surgery after a 1-year follow-up period. Furthermore, potential factors associated with the success rate were investigated.

Methods

All patients were treated at the Clinic of Cranio-Maxillofacial and Oral Surgery at the University of Zurich between 2010 and 2017. To be eligible for inclusion, all patients were required to have undergone apical surgery with a retrograde root-end filling, and a 1-year follow-up examination at the University of Zurich. Treatment success at the 1-year follow-up time-point was defined as an absence of clinical complaints and radiographically determined healing. Parameters that were analysed included tooth localisation, periapical index of the preoperative lesion, administration of antibiotics, smoker status, histopathology of the apical lesion, radiographically determined sufficiency of root canal treatment pain and clinical signs of inflammation at the initial examination.

Results

A total of 81 teeth fulfilled all the inclusion criteria. At the 1-year follow-up, 91.4% of the teeth exhibited successful clinical and radiographic healing. The type of tooth was significantly associated with the success of the surgery (p = 0.006), but radiological severity of periapical inflammation, lesion histopathology, administration of antibiotics, smoker status, the quality of the root canal treatment, and preoperative pain and clinical signs of inflammation were not.

Conclusion

The results of the present study suggest that apical surgery with retrograde root-end filling is a reliable therapy for the preservation of teeth. Furthermore, there are limited factors that affect the treatment outcome.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Kim S, Kratchman S (2006) Modern endodontic surgery concepts and practice: a review. J Endod 32:601–623. https://doi.org/10.1016/j.joen.2005.12.010

    Article  PubMed  Google Scholar 

  2. von Arx T (2001) Periradikuläre Chirurgie-Teil I. Schweiz Monatsschr Zahnmed 111:579–585 https://www.swissdentaljournal.org/fileadmin/upload_sso/2_Zahnaerzte/2_SDJ/SMfZ_2001/SMfZ_05_2001/smfz-01-05-fortbildung2.pdf

    Google Scholar 

  3. von Arx T, Jensen SS, Hänni S, Friedman S (2012) Five-year longitudinal assessment of the prognosis of apical microsurgery. J Endod 38:570–579. https://doi.org/10.1016/j.joen.2012.02.002

    Article  Google Scholar 

  4. von Arx T, Jensen SS, Hänni S (2007) Clinical and radiographic assessment of various predictors for healing outcome 1 year after periapical surgery. J Endod 33:123–128. https://doi.org/10.1016/j.joen.2006.10.001

    Article  Google Scholar 

  5. Setzer FC, Shah SB, Kohli MR, Karabucak B, Kim S (2010) Outcome of endodontic surgery: a meta-analysis of the literature—part 1: comparison of traditional root-end surgery and endodontic microsurgery. J Endod 36:1757–1765. https://doi.org/10.1016/j.joen.2010.08.007

    Article  PubMed  Google Scholar 

  6. Tsesis I, Faivishevsky V, Kfir A, Rosen E (2009) Outcome of surgical endodontic treatment performed by a modern technique: a meta-analysis of literature. J Endod 35:1505–1511. https://doi.org/10.1016/j.joen.2009.07.025

    Article  PubMed  Google Scholar 

  7. Setzer FC, Kohli MR, Shah SB, Karabucak B, Kim S (2012) Outcome of endodontic surgery: a meta-analysis of the literature—part 2: comparison of endodontic microsurgical techniques with and without the use of higher magnification. J Endod 38:1–10. https://doi.org/10.1016/j.joen.2011.09.021

    Article  PubMed  Google Scholar 

  8. von Arx T, Peñarrocha M, Jensen S (2010) Prognostic factors in apical surgery with root-end filling: a meta-analysis. J Endod 36:957–973. https://doi.org/10.1016/j.joen.2010.02.026

    Article  Google Scholar 

  9. Orstavik D, Kerekes K, Eriksen HM (1986) The periapical index: a scoring system for radiographic assessment of apical periodontitis. Endod Dent Traumatol 2:20–34. https://doi.org/10.1111/j.1600-9657.1986.tb00119.x

    Article  CAS  PubMed  Google Scholar 

  10. Brynolf I (1967) A histological and roentgenological study of the periapical region of human upper incisors. Almqvist & Wiksell, Uppsala

    Google Scholar 

  11. Rud J, Andreasen JO, Jensen JEM (1972) Radiographic criteria for the assessment of healing after endodontic surgery. Int J Oral Surg 1:195–214. https://doi.org/10.1016/S0300-9785(72)80013-9

    Article  CAS  PubMed  Google Scholar 

  12. R Core Team (2018) R: A language and environment for statistical computing. R Foundation for Statistical Computing, Vienna, Austria. URL https://www.R-project.org/.

  13. Zuolo ML, Ferreira MOF, Gutmann JL (2000) Prognosis in periradicular surgery: a clinical prospective study. Int Endod J 33:91–98. https://doi.org/10.1046/j.1365-2591.2000.00263.x

    Article  CAS  PubMed  Google Scholar 

  14. Rud J, Andreasen JO, Jensen JEM (1972) A follow-up study of 1,000 cases treated by endodontic surgery. Int J Oral Surg 1:215–228. https://doi.org/10.1016/S0300-9785(72)80014-0

    Article  CAS  PubMed  Google Scholar 

  15. von Arx T, Jensen SS, Janner SFM, Hänni S, Bornstein MM (2019) A 10-year follow-up study of 119 teeth treated with apical surgery and root-end filling with mineral trioxide aggregate. J Endod 45:394–401. https://doi.org/10.1016/j.joen.2018.12.015

    Article  Google Scholar 

  16. Nair PNR, Pajarola G, Schroeder HE (1996) Types and incidence of human periapical lesions obtained with extracted teeth. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 81:93–102. https://doi.org/10.1016/S1079-2104(96)80156-9

    Article  Google Scholar 

  17. Nair PNR, Sjögren U, Schumacher E, Sundqvist G (1993) Radicular cyst affecting a root-filled human tooth: a long-term post-treatment follow-up. Int Endod J 26:225–233. https://doi.org/10.1111/j.1365-2591.1993.tb00563.x

    Article  CAS  PubMed  Google Scholar 

  18. Nair PNR, Sjögren U, Figdor D, Sundqvist G (1999) Persistent periapical radiolucencies of root-filled human teeth, failed endodontic treatments, and periapical scars. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 87:617–627. https://doi.org/10.1016/S1079-2104(99)70145-9

    Article  CAS  PubMed  Google Scholar 

  19. Strbac GD, Schnappauf A, Giannis K, Moritz A, Ulm C (2017) Guided modern endodontic surgery: a novel approach for guided osteotomy and root resection. J Endod 43:496–501. https://doi.org/10.1016/j.joen.2016.11.001

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Eveline Sutter.

Ethics declarations

Conflicts of interest

The authors declare that they have no conflict of interest.

Ethics approval and informed consent

The study protocol was approved by the Cantonal Ethics Committee of Zurich (ID 2018-01085), who waived the usual requirement for informed consent.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Sutter, E., Valdec, S., Bichsel, D. et al. Success rate 1 year after apical surgery: a retrospective analysis. Oral Maxillofac Surg 24, 45–49 (2020). https://doi.org/10.1007/s10006-019-00815-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10006-019-00815-9

Keywords

Navigation