Case selection for apical surgery: a retrospective evaluation of associated factors and rationale

By Abramovitz I, Better H, Schacham A, Shomi B, Metzger Z

Date: 01/2002
Journal: JOE


Purpose: To analyze and evaluate the factors associated with choosing a surgical rather than an orthograde approach to failed endodontic cases

N= 189 patients/ 200 roots


•Cases referred for endodontic surgery during the yrs 1995–2000 were included

•Patient records included: the referral letter, clinical examination & radiographs were examined by an endodontist and oral surgeon.

•The quality of the coronal restoration, the post and RCT was assessed. •Inadequate RCT cases were classified into: 1\Re-tx possible and 2\re-tx impossible

•Adequate RCT cases were classified into: 1\persisting clinical symptoms and 2\ recently done with PA pathology.

Most highlighted Results:

•Surgical treatment was justified in 45% of the cases and unjustified in 55%. (Fig.1)

Clinical significance:

Surgical endodontics should be undertaken only when teeth cannot be treated appropriately by nonsurgical means and in case were adequate RCT failed