04 July 2022

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Evaluation of the effectiveness of apicoectomy performed with the microscope: a retrospective study

Authors: Christian Bacci, Luca Donolato, Alessia Cerrato, Gastone Zanette

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Apical post-treatment pathology can jeopardize the success of endodontic treatment. Various alternatives must be taken into account to promote periapical healing: orthograde retreatment, which is considered the treatment of choice, surgical endodontic retreatment and tooth extraction, in case of failure of the previous treatments. The aim of the present study is to evaluate the efficacy of periapical surgery under operating microscope, at two years follow up time.

MATERIALS AND METHODS
A retrospective cross-sectional study was conducted on 42 teeth from 36 patients. All surgical procedures were performed using an
operating microscope. The criteria to state success or failure were both clinical (swelling, pain, tooth tender to palpation) and radio- graphical (healing and ossification) and all the data have been obtained by consulting clinical folders. Sixteen teeth (drop out rate of 38%) were lost during the follow-up period.

RESULTS
At the 2-year follow-up examination, 25 teeth (96%) showed no adverse clinical manifestations (clinical score = 0). Only one tooth was tender to vestibular palpation (clinical score = 1). Excellent results were also noted for the patients’ pain assess- ment, with 24 teeth (92%) exhibiting no painful symptoms (pain score = 0). Only 2 patients com- plained about a temporary pain- ful condition (pain score = 1). Af- ter 1 year, 23 teeth (81%) showed radiographically a presented with complete osseous healing (regeneration ≥90%) and 3 teeth (11%) exhibited an osseous regeneration between 50% and 90%.

CONCLUSIONS
 What our data seem to suggest is that the operating microscope allows better results mainly acting as an aid to the intraoperative diagnosis.