Clinical outcomes of endodontic microsurgery in complicated cases with large or through-and-through lesions: a retrospective longitudinal study.
Apicoectomy
Complicated cases
Endodontic microsurgery
Large lesions
Through-and-through lesions
Journal
Clinical oral investigations
ISSN: 1436-3771
Titre abrégé: Clin Oral Investig
Pays: Germany
ID NLM: 9707115
Informations de publication
Date de publication:
24 Feb 2024
24 Feb 2024
Historique:
received:
14
05
2023
accepted:
12
02
2024
medline:
26
2
2024
pubmed:
24
2
2024
entrez:
24
2
2024
Statut:
epublish
Résumé
To investigate the clinical outcomes of endodontic microsurgery in complicated cases presenting with large or through-and-through lesions. We retrospectively collected and analyzed preoperative, intraoperative, and follow-up data from 143 complicated cases that underwent endodontic microsurgery. Clinical outcomes were assessed in terms of tooth survival and surgery success. Cox regression analysis was used to evaluate the survival rate and identify associated risk factors. Additionally, the success rate was compared across different postoperative periods, and potential factors contributing to surgical failure were identified through binary logistic regression. The overall survival and success rates were 93.0% and 91.7%, respectively. The Cox regression model identified four risk factors affecting tooth survival, including apicoectomy of four teeth (HR = 35.488; P = 0.0002), an open apex observed on preoperative radiographs (HR = 6.300; P = 0.025), the performance of guided tissue regeneration technique (HR = 8.846; P = 0.028), and a palatal surgical approach (HR = 8.685; P = 0.030). The success rate demonstrated an initial increase in the early postoperative period (from 0.5 to 2 years; P = 5.8124e-30), followed by stabilization (from 2 to 9 years; P = 0.298). Surgery success rate significantly declined when apicoectomy involved four teeth (OR = 109.412; P = 0.002). Endodontic microsurgery demonstrates satisfactory outcomes in complicated cases, maintaining a stable success rate after two years. However, tooth survival and surgery success are significantly compromised when apicoectomy involves four teeth. Factors such as guided tissue regeneration, an open apex, and the palatal surgical approach are associated with an increased risk of tooth extraction. Despite achieving acceptable outcomes in complicated cases, endodontic microsurgery is adversely affected by the apicoectomy of four teeth.
Identifiants
pubmed: 38400913
doi: 10.1007/s00784-024-05557-x
pii: 10.1007/s00784-024-05557-x
doi:
Types de publication
Journal Article
Langues
eng
Pagination
172Subventions
Organisme : Project of Stomatological Hospital, Southern Medical University
ID : KQIIT2021005, RC202204, NTP202201, and PY2020029
Organisme : Project of Stomatological Hospital, Southern Medical University
ID : KQIIT2021005, RC202204, NTP202201, and PY2020029
Organisme : Project of Science and Technology Department, Guangdong Province
ID : KTP2020352
Informations de copyright
© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.
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