Outcomes of Nonsurgical Retreatment and Endodontic Surgery: A Systematic Review

By Torabinejad M, Corr R, Handysides R, Shabahang S

Date: 06/2011
Journal: JOE

Summary: 

Purpose:  to compare the clinical and radiographic success rates of nonsurgical retreatment of root-filled teeth with those of teeth treated by endodontic surgery with a minimum mean follow-up of 2 years.

•Materials/Methods:

Inclusion:

1. Articles from 1970 to 2008 were included that reported radiographical and or clinical outcomes with F/U data of minimum 25 teeth up to 2 years. 2.Literature search with Pubmed, peer reviewed journals, and relevant chapters from 3 endodontic texts with PICO question: In

3.patients with periodontally sound teeth that have had previous endodontic treatment but have persistent periapical pathosis and/or clinical symptoms, does nonsurgical retreatment, compared with endodontic surgery, result in better or worse clinical and/or radiographic outcomes?. 4.Study rating score of 17 points was used to evaluate included articles based on it’s design.

Most highlighted Results: 

  •The final number of endodontic surgery was 26 and NSRCRetx was 8 articles.

•The overall weighted success rate for NSRCRetx was 78% and for surgical endo procedure 75%.

•Success rate at 2-4 years F/U was 78% for surgery and 71% for nonsurgical. •Success rate at 4-6 years F/U was 72% for surgery and 83% for nonsurgical. •Success rate at +6 years F/U was 63% for surgery.

⁻Clinical significance:

    ⁻NSRCRetx should be considered prior to endodontic surgery after failure of primary RCT as long term success rate was higher in non surgical retx.