Treatment decisions in 330 cases referred for apical surgery

By von Arx T, Roux E, Bürgin W.

Date: 08/2015
Journal: JOE


Purpose:  to analyze the treatment decisions offered to patients referred for apical surgery and to evaluate variables that may have influenced the decision-making process.

N= 330 cases 


•The clinical and radiographic data of 330 teeth that had been referred to a specialist in apical surgery were assessed with regard to the treatment decisions made in those teeth.

•The clinical and radiographic variables were divided into subcategories to analyze which factors influenced the decision-making process (table.3).

Most highlighted Results: 

•The treatment decisions included apical surgery (59.1%), tooth extraction (25.8%), no treatment (9.1%), and nonsurgical endodontic retreatment (6.1%).

•Variables that showed statistically significant differences comparing treatment decisions among subcategories included probing depth, clinical attachment level, tooth mobility, pain, clinical signs, length and quality of the root canal filling, and size and location of the periapical lesion (table.3) •The strongest indicators for ‘‘tooth extraction,’’, were a probing depth equal or greater than 4 mm (89.3%) and a lesion not located at the apex (86.1%).


•This study shows that apical surgery was the most frequently made treatment decision in teeth referred to a specialist in apical surgery, but every fourth tooth was considered nonretainable and was scheduled for extraction.

•the most common variables that influenced the decision to extract teeth were teeth with an increased probing depth and tooth mobility and teeth presenting with lesions not located at the apex.