Clinical management of nonhealing periradicular pathosis Surgery versus endodontic retreatment

By Danin J, Strömberg T, Forsgren H, Linder LE, Ramsköld LO

Date: 09/1997
Journal: OOO



To compare the treatment outcome of non-healing PA lesion when managed by NSRC-ReTx or surgery.

N= 38, (19/group) either RE-TX or surgery, anteriors and premolars


 Re-Tx: under RD isolation, the canals enlarged 2 sizes larger than 1st binding file, placement of Ca(OH)2 for 3 months. Obturation with lateral condensation. 0.5% NaOCl was used. 

Surgery: mucoperiosteal flap was elevated, 2-3 mm was resectioned, 2 mm cavity was prepared using round bur, GIC filling.  Suturing.

•After 1 year the treatment outcome assessed according to the criteria of Rud et al.1972: complete healing, incomplete healing (scar tissue), uncertain healing; and, unsatisfactory healing (failure).

Most highlighted Results:

•The success rate for surgery was higher than retreatment, but the difference was not significant.

• No positive correlation was observed between the different healing groups and the size of the apical lesion or the quality of the previous root canal fillings.

Clinical significance

For management of non-healing periradicular pathosis after RCT, surgical intervention should be considered as one of the treatment  options