Study Reveals Predictors of Success in Endodontic Microsurgery

CHINA: Researchers from the Peking University School and Hospital of Stomatology, along with several renowned dental institutions, have conducted a retrospective cohort study shedding light on the clinical outcomes and predictive factors in endodontic microsurgery. 

The study, titled “Clinical Outcome and Predictors of Endodontic Microsurgery Using Cone-beam Computed Tomography,” offers valuable insights into this specialised dental procedure.

The primary objective of this comprehensive study was to assess the clinical outcomes of endodontic microsurgery while pinpointing the factors that influence its success. The research focused on patients who had undergone endodontic microsurgery in teeth afflicted with asymptomatic apical periodontitis.

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Evaluating Clinical Outcomes

The researchers evaluated the clinical outcomes through a combination of clinical and radiographic examinations conducted 12 to 48 months post-surgery. Radiographic healing was a pivotal aspect, assessed using cone-beam computed tomography (CBCT) images with the modified PENN 3-dimensional criteria. The healing outcomes were classified into four categories: complete, limited, uncertain, and unsatisfactory healing.

Of the 204 teeth from 173 patients initially enrolled in the study, 148 teeth belonging to 126 patients underwent thorough examination during the review process. The CBCT images showcased promising results, with 88 teeth (59.5%) demonstrating complete healing, and 42 teeth (28.4%) displaying limited healing. Importantly, all 130 of these teeth were asymptomatic, achieving an impressive clinical success rate of 87.8%.

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Predicting Outcomes

The study also delved into the factors influencing treatment outcomes. Uncertain healing was observed in nine teeth, one of which was symptomatic, while the remaining nine teeth showed unsatisfactory healing on CBCT scans. Notably, lesion type and the quality of root-end filling emerged as significant predictors of treatment outcomes.

The research revealed a noteworthy finding: teeth with combined endodontic-periodontal lesions faced an 8.6 times higher risk of treatment failure compared to teeth with isolated endodontic lesions. Furthermore, the quality of root-end filling played a pivotal role, improving the probability of success by 5.3 times.

Glimpse into the Future

This study, anchored in CBCT data, offers a significant stride forward in understanding the factors that determine the success of endodontic microsurgery. The findings emphasise the importance of meticulous technique and underscore the potential for predictable success in cases devoid of periodontal involvement.

As the dental field continues to advance, studies like these provide crucial guidance for practitioners, enhancing patient care and treatment outcomes.

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