Abstract
Data sources
Medline, Embase and reference lists of identified articles were used to find relevant publications; searches were limited to English language.
Study selection
Randomised control trials (RCT) or prospective case series of surgical endodontic treatments performed by a modern technique using magnification, root-end resection with minimal or no bevel, retrograde cavity preparation with ultrasonic tips, and retrograde root canal filling where the lesion was located at the periapical area, with a minimum of 1-year followup and outcomes assessed according to the Rud 1 or Molven 2 criteria, were included. Studies that did not use a modern surgical approach, involved teeth with apico-marginal defects, periodontal disease, root fractures and root perforations or undergoing repeat surgery were excluded, as were those with less than 1-year followup and with outcomes not evaluated using the Rud 1 or Molven 2 criteria.
Data extraction and synthesis
Studies were reviewed and data extracted independently by three observers, with disagreements resolved by discussion. Studies included were combined to estimate the pooled successes and 95% confidence intervals (CI), where success was considered to be complete healing or incomplete healing, by using generalised linear models, assuming a binomial (proportion) distribution.
Results
Eleven studies (six RCT and five prospective case series) met the criteria. The pooled proportion of treatments deemed to be a success (complete healing and incomplete healing) was found to be 91.6% (95% CI, 85.9–95.1%). The pooled proportion deemed to be failures was found to be 4.7% (95% CI, 2.24–9.50%). The remainder were categorised as of uncertain healing (3.7%)
Conclusions
Surgical endodontic treatment carried out using a modern technique carries predictable outcomes. Additional large-scale prospective clinical studies are needed to evaluate further predictors of success and failure.
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Acknowledgements
Dr Azarpazhooh thanks Professor Shimon Friedman, Faculty of Dentistry, University of Toronto, for his thoughtful inputs on this commentary.
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Additional information
Address for correspondence: Dr Igor Tsesis, Tel Aviv University Dental School, Maurice and Gabriela Goldschleger School of Dental Medicine, Department of Endodontology, Tel Aviv, Israel. E-mail: dr.tsesis@gmail.com
Tsesis I, Faivishevsky V, Kfir A, Rosen E. Outcome of surgical endodontic treatment performed by a modern technique: a meta-analysis of the literature. J Endod 2009; 35: 1505–1511
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Azarpazhooh, A. Surgical endodontic treatment under magnification has high success rates. Evid Based Dent 11, 71–72 (2010). https://doi.org/10.1038/sj.ebd.6400733
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DOI: https://doi.org/10.1038/sj.ebd.6400733
