The Study of Bone Healing After Endodontic Microsurgery Using Cone Beam Computed Tomography: A Retrospective Cohort Study

Overview

Journal J Clin Exp Dent

Specialty Dentistry

Date 2022 Sep 1

PMID 36046171

Authors

Amparo Ramis-Alario

Beatriz Tarazona-Alvarez

Miguel Penarrocha-Diago

David Soto-Penaloza

Maria Penarrocha-Diago

David Penarrocha-Oltra

Affiliations

Soon will be listed here.

Abstract

Background: The main aims of this study were to evaluate mean volume reduction, radiographic healing rate and healing outcome two years after endodontic microsurgery. The effects of certain preoperative clinical factors upon preoperative volume, volumetric changes and healing outcome were also studied.

Material And Methods: A clinical database was searched for patients who had undergone endodontic microsurgery and with the availability of a cone beam computed tomography (CBCT) scan preoperatively and after a control period. Volumetric analysis of the periapical area was made to assess volumetric reduction. The modified Penn 3D criteria were applied. The relationship between preoperative volume, volumetric reduction and healing outcome and certain preoperative factors was also studied.

Results: Fifty-seven cases were evaluated. Initially, the bone cavities had a median volume of 163.2 mm3, and this volume decreased by 147.7 mm3 after treatment, with a radiographic healing rate of 6.2 mm3 per month. After applying the modified Penn 3D Criteria, 53 cases were classified as successful healing (93%). Regarding the influence of the different preoperative factors, patient age and sex, dental arch and cortical bone significantly influenced preoperative volume, while only the dental arch exerted a significant influence upon volumetric changes and preoperative symptoms on healing outcome.

Conclusions: The CBCT data evidenced a significant volume reduction of 79.1%, with a monthly volume reduction rate of 6.2 mm3. The success rate obtained was 93%. Patient age and sex, dental arch and cortical bone influenced preoperative volume, tooth type had an impact upon the volumetric changes, and the preoperative symptoms influenced healing outcome. Cone beam computed tomography, endodontic microsurgery, healing, lesion volume, prognostic factors.

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References

Ogutlu F, Karaca I . Clinical and Radiographic Outcomes of Apical Surgery: A Clinical Study. J Maxillofac Oral Surg. 2018; 17(1):75-83. PMC: 5772023. DOI: 10.1007/s12663-017-1008-9. View

Li H, Zhai F, Zhang R, Hou B . Evaluation of microsurgery with SuperEBA as root-end filling material for treating post-treatment endodontic disease: a 2-year retrospective study. J Endod. 2014; 40(3):345-50. DOI: 10.1016/j.joen.2013.11.001. View

von Arx T, Kurt B . Root-end cavity preparation after apicoectomy using a new type of sonic and diamond-surfaced retrotip: a 1-year follow-up study. J Oral Maxillofac Surg. 1999; 57(6):656-61. DOI: 10.1016/s0278-2391(99)90424-x. View

Cheung G, Wei W, McGrath C . Agreement between periapical radiographs and cone-beam computed tomography for assessment of periapical status of root filled molar teeth. Int Endod J. 2013; 46(10):889-95. DOI: 10.1111/iej.12076. View

Safi C, Kohli M, Kratchman S, Setzer F, Karabucak B . Outcome of Endodontic Microsurgery Using Mineral Trioxide Aggregate or Root Repair Material as Root-end Filling Material: A Randomized Controlled Trial with Cone-beam Computed Tomographic Evaluation. J Endod. 2019; 45(7):831-839. DOI: 10.1016/j.joen.2019.03.014. View

Soto-Penaloza D, Penarrocha-Diago M, Cervera-Ballester J, Penarrocha-Diago M, Tarazona-Alvarez B, Penarrocha-Oltra D . Pain and quality of life after endodontic surgery with or without advanced platelet-rich fibrin membrane application: a randomized clinical trial. Clin Oral Investig. 2019; 24(5):1727-1738. DOI: 10.1007/s00784-019-03033-5. View

Landis J, Koch G . The measurement of observer agreement for categorical data. Biometrics. 1977; 33(1):159-74. View

Halse A, Molven O, Grung B . Follow-up after periapical surgery: the value of the one-year control. Endod Dent Traumatol. 1991; 7(6):246-50. DOI: 10.1111/j.1600-9657.1991.tb00211.x. View

Jorge E, Tanomaru-Filho M, Guerreiro-Tanomaru J, Reis J, Spin-Neto R, Goncalves M . Periapical repair following endodontic surgery: two- and three-dimensional imaging evaluation methods. Braz Dent J. 2015; 26(1):69-74. DOI: 10.1590/0103-6440201300252. View

10.

Parmar P, Dhamija R, Tewari S, Sangwan P, Gupta A, Duhan J . 2D and 3D radiographic outcome assessment of the effect of guided tissue regeneration using resorbable collagen membrane in the healing of through-and-through periapical lesions - a randomized controlled trial. Int Endod J. 2019; 52(7):935-948. DOI: 10.1111/iej.13098. View

11.

Setzer F, Kohli M, Shah S, Karabucak B, Kim S . Outcome of endodontic surgery: a meta-analysis of the literature--Part 2: Comparison of endodontic microsurgical techniques with and without the use of higher magnification. J Endod. 2011; 38(1):1-10. DOI: 10.1016/j.joen.2011.09.021. View

12.

Lemagner F, Maret D, Peters O, Arias A, Coudrais E, Georgelin-Gurgel M . Prevalence of Apical Bone Defects and Evaluation of Associated Factors Detected with Cone-beam Computed Tomographic Images. J Endod. 2015; 41(7):1043-7. DOI: 10.1016/j.joen.2015.03.011. View

13.

Lopez F, Kopper P, Cucco C, Della Bona A, de Figueiredo J, Vier-Pelisser F . Accuracy of cone-beam computed tomography and periapical radiography in apical periodontitis diagnosis. J Endod. 2014; 40(12):2057-60. DOI: 10.1016/j.joen.2014.09.003. View

14.

Estrela C, Bueno M, Leles C, Azevedo B, Azevedo J . Accuracy of cone beam computed tomography and panoramic and periapical radiography for detection of apical periodontitis. J Endod. 2008; 34(3):273-9. DOI: 10.1016/j.joen.2007.11.023. View

15.

Penarrocha Diago M, Ortega Sanchez B, Garcia Mira B, Marti Bowen E, von Arx T, Gay Escoda C . Evaluation of healing criteria for success after periapical surgery. Med Oral Patol Oral Cir Bucal. 2008; 13(2):E143-7. View

16.

von Arx T, Jensen S, Hanni S, Friedman S . Five-year longitudinal assessment of the prognosis of apical microsurgery. J Endod. 2012; 38(5):570-9. DOI: 10.1016/j.joen.2012.02.002. View

17.

Davies A, Mannocci F, Mitchell P, Andiappan M, Patel S . The detection of periapical pathoses in root filled teeth using single and parallax periapical radiographs versus cone beam computed tomography - a clinical study. Int Endod J. 2014; 48(6):582-92. DOI: 10.1111/iej.12352. View

18.

Patel S, Wilson R, Dawood A, Mannocci F . The detection of periapical pathosis using periapical radiography and cone beam computed tomography - part 1: pre-operative status. Int Endod J. 2011; 45(8):702-10. DOI: 10.1111/j.1365-2591.2011.01989.x. View

19.

Christiansen R, Kirkevang L, Gotfredsen E, Wenzel A . Periapical radiography and cone beam computed tomography for assessment of the periapical bone defect 1 week and 12 months after root-end resection. Dentomaxillofac Radiol. 2009; 38(8):531-6. DOI: 10.1259/dmfr/63019695. View

20.

Curtis D, VanderWeele R, Ray J, Wealleans J . Clinician-centered Outcomes Assessment of Retreatment and Endodontic Microsurgery Using Cone-beam Computed Tomographic Volumetric Analysis. J Endod. 2018; 44(8):1251-1256. DOI: 10.1016/j.joen.2018.03.016. View