Five-Year Longitudinal Assessment of the Prognosis of Apical Microsurgery
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| Title: | Five-Year Longitudinal Assessment of the Prognosis of Apical Microsurgery |
|---|---|
| Authors: | Stefan Hänni, Simon Storgård Jensen, Thomas von Arx, Shimon Friedman |
| Source: | Journal of Endodontics. 38:570-579 |
| Publisher Information: | Elsevier BV, 2012. |
| Publication Year: | 2012 |
| Subject Terms: | Male, Silicates/therapeutic use, Microsurgery, Alveolar Process/pathology, Retrograde Obturation/methods, Aluminum Compounds/therapeutic use, Apicoectomy/methods, Cohort Studies, Root Canal Filling Materials, 03 medical and health sciences, Bisphenol A-Glycidyl Methacrylate/therapeutic use, 0302 clinical medicine, Wound Healing/physiology, Periapical Periodontitis/surgery, Alveolar Process, Humans, Single-Blind Method, Bisphenol A-Glycidyl Methacrylate, Longitudinal Studies, Aluminum Compounds, Root Canal Filling Materials/therapeutic use, Dentin-Bonding Agents/therapeutic use, Apicoectomy, Oxides, Oxides/therapeutic use, Calcium Compounds, Middle Aged, Prognosis, Microsurgery/methods, Drug Combinations, Treatment Outcome, Dentin-Bonding Agents, Retrograde Obturation, Female, Calcium Compounds/therapeutic use, Tooth Cervix/pathology, Periapical Periodontitis, Follow-Up Studies |
| Description: | Apical surgery is an important treatment option for teeth with post-treatment apical periodontitis. Knowledge of the long-term prognosis is necessary when weighing apical surgery against alternative treatments. This study assessed the 5-year outcome of apical surgery and its predictors in a cohort for which the 1-year outcome was previously reported.Apical microsurgery procedures were uniformly performed using SuperEBA (Staident International, Staines, UK) or mineral trioxide aggregate (MTA) (ProRoot MTA; Dentsply Tulsa Dental Specialties, Tulsa, OK) root-end fillings or alternatively Retroplast capping (Retroplast Trading, Rorvig, Denmark). Subjects examined at 1 year (n = 191) were invited for the 5-year clinical and radiographic examination. Based on blinded, independent assessment by 3 calibrated examiners, the dichotomous outcome (healed or nonhealed) was determined and associated with patient-, tooth-, and treatment-related variables using logistic regression.At the 5-year follow-up, 9 of 191 teeth were unavailable, 12 of 191 teeth were extracted, and 170 of 191 teeth were examined (87.6% recall rate). A total of 129 of 170 teeth were healed (75.9%) compared with 83.8% at 1 year, and 85.3% were asymptomatic. Two significant outcome predictors were identified: the mesial-distal bone level at ≤ 3 mm versus >3 mm from the cementoenamel junction (78.2% vs 52.9% healed, respectively; odds ratio = 5.10; confidence interval, 1.67-16.21; P < .02) and root-end fillings with ProRoot MTA versus SuperEBA (86.4% vs. 67.3% healed, respectively; odds ratio = 7.65; confidence interval, 2.60-25.27; P < .004).This study suggested that the 5-year prognosis after apical microsurgery was 8% poorer than assessed at 1 year. It also suggested that the prognosis was significantly impacted by the interproximal bone levels at the treated tooth and by the type of root-end filling material used. |
| Document Type: | Article |
| Language: | English |
| ISSN: | 0099-2399 |
| DOI: | 10.1016/j.joen.2012.02.002 |
| DOI: | 10.48350/11214 |
| Access URL: | https://pubmed.ncbi.nlm.nih.gov/22515881 https://www.sciencedirect.com/science/article/pii/S0099239912001604 http://core.ac.uk/display/33039675 https://boris.unibe.ch/11214/ https://pubmed.ncbi.nlm.nih.gov/22515881/ https://www.ncbi.nlm.nih.gov/pubmed/22515881 http://www.sciencedirect.com/science/article/pii/S0099239912001604 |
| Rights: | Elsevier TDM |
| Accession Number: | edsair.doi.dedup.....b074f65b6633c66269f631bcc02a4e17 |
| Database: | OpenAIRE |
Nájsť tento článok vo Web of Science | Abstract: | Apical surgery is an important treatment option for teeth with post-treatment apical periodontitis. Knowledge of the long-term prognosis is necessary when weighing apical surgery against alternative treatments. This study assessed the 5-year outcome of apical surgery and its predictors in a cohort for which the 1-year outcome was previously reported.Apical microsurgery procedures were uniformly performed using SuperEBA (Staident International, Staines, UK) or mineral trioxide aggregate (MTA) (ProRoot MTA; Dentsply Tulsa Dental Specialties, Tulsa, OK) root-end fillings or alternatively Retroplast capping (Retroplast Trading, Rorvig, Denmark). Subjects examined at 1 year (n = 191) were invited for the 5-year clinical and radiographic examination. Based on blinded, independent assessment by 3 calibrated examiners, the dichotomous outcome (healed or nonhealed) was determined and associated with patient-, tooth-, and treatment-related variables using logistic regression.At the 5-year follow-up, 9 of 191 teeth were unavailable, 12 of 191 teeth were extracted, and 170 of 191 teeth were examined (87.6% recall rate). A total of 129 of 170 teeth were healed (75.9%) compared with 83.8% at 1 year, and 85.3% were asymptomatic. Two significant outcome predictors were identified: the mesial-distal bone level at ≤ 3 mm versus >3 mm from the cementoenamel junction (78.2% vs 52.9% healed, respectively; odds ratio = 5.10; confidence interval, 1.67-16.21; P < .02) and root-end fillings with ProRoot MTA versus SuperEBA (86.4% vs. 67.3% healed, respectively; odds ratio = 7.65; confidence interval, 2.60-25.27; P < .004).This study suggested that the 5-year prognosis after apical microsurgery was 8% poorer than assessed at 1 year. It also suggested that the prognosis was significantly impacted by the interproximal bone levels at the treated tooth and by the type of root-end filling material used. |
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| ISSN: | 00992399 |
| DOI: | 10.1016/j.joen.2012.02.002 |