Prognosis in periradicular surgery: a clinical prospective study

Abstract

Aim: The purpose of this prospective study was to evaluate the prognosis of periradicular surgery using well-defined case selection and a rigorous surgical protocol.

Methodology: Teeth to be treated surgically demonstrated a periradicular lesion of strictly endodontic origin with or without clinical signs and symptoms of inflammation. A total of 114 teeth were treated. Following the reflection of a full mucoperiosteal tissue flap, residual soft tissues were curetted, root ends were resected with a fine high-speed diamond bur, root-end cavities were prepared ultrasonically with diamond tips, and IRM root-end fillings were placed. Cases were followed clinically and radiographically for a period ranging from 1 to 4 years.

Results: The results of this study showed 91.2% success out of a total of 102 teeth available for follow-up, based on accepted parameters of evaluation. Cases were considered successful if there were no clinical signs or symptoms present and there was radiographic evidence of complete or incomplete healing (scar tissue). Factors related to case selection, parameters of healing and surgical technique are discussed in relation to the success rate identified in this prospective study.

Conclusions: Adherence to a strict endodontic surgical protocol and the use of contemporary techniques and materials will result in a predictably successful outcome in a wide range of teeth.