Correlation of Bone Defect Dimensions with Healing Outcome One Year after Apical Surgery

By von Arx T, Hänni S, Jensen SS.

Date: 10/2007
Journal: JOE

Summary:

  •Purpose:  to assess the influence of bone defect dimensions on outcome 1 year after apical surgery.

• N= 183 teeth in an equal number of patients.

•Materials/Methods: 

  •Apical surgery was performed. Bone dimensions (Fig. 1) were measured after resection.

•Patients were recalled 1 year after surgery for clinical & radiographic reexamination.

•Healing at the 1-year follow-up was judged & independently evaluated by 3 authors.

•In healed cases, the radiograph demonstrated complete or incomplete healing, and no clinical signs and symptoms were present. In non-healed cases, the radiographic healing was assessed as uncertain or unsatisfactory, or clinical signs or symptoms were present.

Most highlighted Results: 

  1.Dropout rate of 3.3%. The overall success rate (healed cases) was 83%. 2.Statistically significant differences were found for the length of the access window (D), as well as for the depth (E) and approximate volume (V) of the bony crypt when comparing measurements for healed and non-healed cases.

3.The calculated mean crypt volume in healed cases was 395 mm3, compared with 554 mm3 in non-healed cases.

4.The greatest difference between healed & non-healed was for the mesiodistal distance (length) of access window to the bony crypt D (7.04 vs 8.60 mm).

5.The evaluation of the canal access distance (F) showed a significantly shorter mean distance in healed cases (4.30 mm) than in non-healed cases (5.13 mm).

Conclusion : 

  •the size of the bony crypt and the canal access distance were correlated with healing at reexamination; non-healed cases presented larger bony crypts and greater canal access distances at the time of apical surgery than healed cases.