Apical surgery vs apical surgery with simultaneous orthograde retreatment: A prospective cohort clinical study of teeth affected by persistent periapical lesion

Aim: This prospective clinical study analyzed the 24-month outcome of conventional apical surgery retro-filled with calcium-silicate cement versus apical surgery with simultaneous orthograde retreatment by means of clinical and radiographic criteria. Materials and methods: This study included 83 tee...

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Main Authors: Azizi, A. (Author), Gandolfi, M.G (Author), Iacono, F. (Author), Montebugnoli, L. (Author), Pirani, C. (Author), Prati, C. (Author), Zamparini, F. (Author)
Format: Article
Language:English
Published: Masson SpA 2018
Subjects:
MTA
Online Access:View Fulltext in Publisher
LEADER 03797nam a2200601Ia 4500
001 10.1016-j.gien.2018.03.001
008 220706s2018 CNT 000 0 und d
020 |a 11214171 (ISSN) 
245 1 0 |a Apical surgery vs apical surgery with simultaneous orthograde retreatment: A prospective cohort clinical study of teeth affected by persistent periapical lesion 
260 0 |b Masson SpA  |c 2018 
856 |z View Fulltext in Publisher  |u https://doi.org/10.1016/j.gien.2018.03.001 
520 3 |a Aim: This prospective clinical study analyzed the 24-month outcome of conventional apical surgery retro-filled with calcium-silicate cement versus apical surgery with simultaneous orthograde retreatment by means of clinical and radiographic criteria. Materials and methods: This study included 83 teeth affected by persistent periapical lesions in 68 patients. Mean age was 52 years (median = 51 years; range 19–81 years). Twenty-eight cases were treated with apical surgery, 16 cases with apical surgery with simultaneous orthograde retreatment and 39 cases with orthograde retreatment in previously treated teeth established as control group. Periapical index score (PAI) was used as radiographic criteria. Teeth were examined at 6 months, 1 and 2 years and classified as healed (without any symptoms and PAI ≤ 2), healing (without any symptoms and PAI = 3) or diseased (with symptoms or PAI ≥ 4 and not functional) on the basis of radiographic and clinical criteria. At 24 months evaluation, healed and healing were considered as success and diseased and fracture as failure. Multilevel GLM model and an ordered logistic regression as statistical analysis was made with level of significance set at p < 0.05. Results: Total drop-out was 7% (n = 6). After 6–9 months, 6 teeth (3 from apical surgery, 2 from simultaneous treatment and 1 from orthograde retreatment) were extracted for root fracture. Twenty-four-month success rate of apical surgery group was 78% (n = 17), apical surgery with simultaneous orthograde retreatment presented 81% (n = 10) and orthograde retreatment success was 80% (n = 24). There was no statistically difference between the groups at 24 months (p = 0.890). Conclusions: Both surgical techniques revealed a high percentage of healing, similar to that reported by previous studies. Apical surgery with simultaneous orthograde retreatment showed a faster healing after 12 months comparing to the control group. © 2018 Società Italiana di Endodonzia 
650 0 4 |a adult 
650 0 4 |a aged 
650 0 4 |a Apical surgery 
650 0 4 |a apical surgery with simultaneous orthograde retreatment 
650 0 4 |a Article 
650 0 4 |a calcium silicate 
650 0 4 |a carboplyina 
650 0 4 |a central incisor 
650 0 4 |a clinical outcome 
650 0 4 |a clinical study 
650 0 4 |a dental surgery 
650 0 4 |a Endodontics 
650 0 4 |a female 
650 0 4 |a healing 
650 0 4 |a human 
650 0 4 |a major clinical study 
650 0 4 |a male 
650 0 4 |a maxillary canine 
650 0 4 |a maxillary first premolar 
650 0 4 |a mepivacaine 
650 0 4 |a middle aged 
650 0 4 |a MTA 
650 0 4 |a Periapical index score 
650 0 4 |a periodontal disease assessment 
650 0 4 |a persistent periapical lesion 
650 0 4 |a prospective study 
650 0 4 |a retreatment 
650 0 4 |a Retreatment 
650 0 4 |a tooth apex 
650 0 4 |a tooth cement 
650 0 4 |a tooth periapical disease 
650 0 4 |a tooth radiography 
650 0 4 |a Treatment 
700 1 |a Azizi, A.  |e author 
700 1 |a Gandolfi, M.G.  |e author 
700 1 |a Iacono, F.  |e author 
700 1 |a Montebugnoli, L.  |e author 
700 1 |a Pirani, C.  |e author 
700 1 |a Prati, C.  |e author 
700 1 |a Zamparini, F.  |e author 
773 |t Giornale Italiano di Endodonzia