Results of apicoectomy of maxillary canines, premolars, and molars with special reference to oroantral communication as a prognostic factor

By Ericson S, Finne K, Persson G

Date: 05/1974
Journal: Oral Surg Oral Med Oral Patho

Purpose:  to study the effect of OAC on case prognosis of teeth undergoing endodontic surgery as well as the effect of OAC on Maxillary Sinus status. •

N =  314 teeth

Materials/Methods:

•Patients aged between 12-71 years.

•Follow up at 6, 12 and 36 months after the operation; up to 12 years. •Conventional surgical procedure performed. Retrograde included amalgam, GP and Cavit.

•Oroantral communication (OAC) was noted in 41 (13 %) of the cases. •Classification of the results of apicoectomy:

Successful, when the apical area showed complete bone regeneration with or without periodontal membrane

Uncertain, when certain degree of bone regeneration had occurred but a radiolucency was still demonstrable

Unsuccessful, when there was no bone regeneration or an increased radiolucency and/or demonstrable resorption of the root.

Classification of sinus status: if the mucosa was:

•less than 5 mm thick= moderate hyperplasia;

•thicker =severe

Most highlighted Results: 

1.No difference between the results obtained in the groups without  and with OAC

2.The results of the operation in the group with ruptured sinus mueosa did not differ from those in the group with intact mucousa

3.Canines were better outcome than the 1st and 2nd premolars

4.No significant difference between 1st and 2nd premolars

5.Nothing suggested that OAC had affected the results of treatment

6.Factors such as retrograde root filling, quality of the orthograde root filling, preoperative root resorption and extent of periapical destruction did not demonstrate any effect on the result

7.Frequency of success was 25 % higher when lesion proved to be a cyst than a granuloma.

Clinical significance:  

•Prevention is the best treatment; proper evaluation of the case and diagnostic imaging to anticipate the path of procedure is favorable.