Relationship of Periapical Lesion Radiologic Size, Apical Resection, and Retrograde Filling With the Prognosis of Periapical Surgery

By Penarrocha M , Marti E, Garcia B

Date: 06/2007
Journal: Oral Surg Oral Med Oral Patho

Summary: 

Purpose:  to correlate between radiographic size of the lesion , apical resection and retrograde filling to long-term success to periapical surgery

Materials/Methods:

• N : 235 patients and 333teeth  were included in this study ( 176 in the maxilla and 157 in the mandible ) 

•Inclusion criteria : 

1- teeth with apicectomies  and ultrasound preparation followed by amalgam retrograde filling 

•Follow up duration  at least 1 year  after surgery and up to 10 years

•Before the surgery , they  measured the size of the periapical lesion (by using  3X magnifying glass )

Most highlighted Results:

-The mean maximum diameter  of the periapical lesion was 7.4 mm and the minimum diameter was 5 mm

-The mean resection area was 6.48 mm2; the mean height of resection was 2.7 mm and the mean base was 2.4 mm

-The mean area of the retrograde fillings was 3.05 mm2.The mean height was 2.25 mm and the mean width was 1.1 mm

-The prognosis of periapical surgery improved with smaller periapical lesions and lesser apical resection  ( less than 5 ml) while the dimension of retrograde filling is not related to  treatment success or failure

-The maxillary incisors and canine teeth had the best prognosis; the mandibular incisors and canine teeth had the worst

Clinical significance: 

  • Dimension of apical resection should be conservative in order to have better prognosis