Prognostic Factors in Apical Surgery with Root-end Filling: A Meta-analysis

By von Arx T, Hänni S, Jensen SS

Date: 10/2011
Journal: JOE


Purpose:  to perform an updated meta-analysis to assess potential prognostic factors for healing outcome in apical surgery with root-end filling by reviewing all levels of clinical evidence.


⁻Inclusion: Clinical trials with clearly defined radiographical and clinical healing criteria with at least 2 categories of specific prognostic factors. ⁻Literature search with Pubmed and Chocrane library in 2008 including articles from 1980 to 2007.

Most highlighted Results:

    ⁻The final number of clinical studies was 38.

⁻Pt related factors:

⁻Gender and age did not sig affect healing rate.

⁻Tooth related factors:

⁻ Mandibular molars had the lowest healed rate 64% but was only sig different from Max Pm.

⁻Presence of pre-op signs and symptoms, density of RC filling, presence of PAL, and size of PAL had sig affected healing rate.

⁻Tx related factors:

⁻Use of microtip prep and 1st time surgery were sig tx prognostic factors. ⁻MTA had the highest healing rate (91%) when compared to Retroplast (80%) IRM (72%), Super EBA (70%) and GIC (51%).

⁻Clinical significance:   

⁻Decision making in endodontic surgery should rely on prognostic factors to form a patient centered tx approach.