Outcome of Endodontic Surgery : a meta-analysis of the literature part I: Comparison of Traditional root-end surgery and Endodontic Microsurgery

By Setzer FC, Shah SB, Kohli MR, Karabucak B, Kim S

Date: 03/2011
Journal: JOE

Purpose: to investigate the specific outcome of traditional root-end surgery (TRS) versus endodontic microsurgery (EMS) and the probability of success for comparison of the 2 techniques.

N=  21 studies (12 TRS, 9 EMS)

Materials/Methods:

•A well defined review question was developed by using PICO framework ” Teeth that have undergone a root end surgery  & root end filling procedure by EMS compared to TRS have what expected probability of success according to longitudinal studies with strictly defined inclusion & exclusion criteria” ?

•3 Electronic data bases  were searched to identify human studies from 1966 to October 2009 in 5 (different languages, journals) through 3 independent reviewers .

Inclusion :

(1)Humans clinical study on root end surgery

(2) sample size given

(3) minimum follow up period of 6 months

(4) success & failure evaluated by using radiographic parameters & clinical assessment of Rud et la.

(5)  Success and failure were evaluated per tooth.

(6) The overall success rate was given for the specific technique or could be calculated from the raw data.

(7). The method used in the study strictly followed either the specific techniques for TRS  or for EMS

Exclusion:

Any study that did not meet the criteria above in addition to

(1) lesions > 10 mm

(2) apico-marginal defects or teeth with periodontal defects.

(3) Re-surgery cases or root resections & amputations, and (4) cases presenting with root fractures or perforations.

Most highlighted Results: 

•The TRS group included 12 studies with a weighted pooled success rate of 59%. •The EMS group included 9 studies with a weighted pooled success rate of  94%.

Clinical significance:

The probability of success for EMS proved significantly greater than the probability of success for TRS