20 April 2021

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Surgical root canal retreatment to heal periapical lesion

Alessandra Abbà

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Surgical root canal retreatmentis a surgery procedure performed to remove lesions around the apex of a tooth. This apical surgery is indicated when radiological findings of apical pathology are detected and conventional orthograde endodontic treatment is not recommended. The procedure involves the apex resection followed by apex filling. The aim of the retrograde filling is to provide an apical seal to the canal, and the regeneration of periradicular tissues eliminating bacterial contamination. 

The healing of periapical lesion after conventional orthograde endodontic treatment has been object of several studies. However few studies have investigated the healing of periapical lesion after surgical root canal retreatment which in the last years has exhibited promising success rate, thanks to the improved microsurgical techniques. 

So the aim of this systematic review is to collect data about surgical root canal retreatmentto heal the periapical lesion.

 Materials and methods: A web search was done through PubMed (2009-2019) and Google Scholar (2009-2019) with MesH terms in various combinations and setting specific inclusion and exclusion criteria. Among 3900 studies, 10 studies satisfied the eligibility criteria criteria as well as PRISMA guidelines and were included in the review to be analyzed.

Results: The studies included in this systematic review were one randomized controlled trial study, two prospective studies, one etrospective study, and six case reports.

The 10 selected studies analyze the surgical root canal retreatmentas a treatment option in removing infections and in particular the healing of periapical lesion investigating success rates, follow-up duration, and updated studies insurgical root canal retreatment. 

Conclusions: Although conventional orthograde endodontic treatment must always be considered first, on specific cases a surgical approach can be indicated.

Surgical root canal retreatmentdemonstrates its efficiency in reducing the period needed for healing of the periapical lesion in short-term follow-up but on the long-term follow-up showed not significant difference for healing of periapical lesion compared to conventional orthogradeendodontic treatment.

For additional information: Healing of Periapical Lesions After Surgical Endodontic Retreatment: A Systematic Review