Outcomes of nonsurgical retreatment and endodontic surgery: a systematic review.

By Torabinejad M, Corr R, Handysides R, Shabahang S

Date: 11/2009
Journal: JOE

Summary: 

Purpose: to compare the clinical and radiographic outcomes of nonsurgical retreatment with those of endodontic surgery

Materials/Methods:

on: 26 endodontic surgery articles and 8 articles of non surgical RCT

o inclusion:

oArticles from peer-reviewed journals published in English from 1970–2008 and reporting clinical and/or radiographic outcomes for at least a mean follow-up of 2 years

oPICO question: In patients with periodontally sound teeth that have had previous endodontic treatment but have persistent periapical pathosis and/or clinical symptoms, does nonsurgical retreatment, compared with endodontic surgery, result in better or worse clinical and/or radiographic outcomes?

oMEDLINE, PubMed, and Cochrane databases were searched followed with exhaustive hand searching.

oPooled and weighted success rates were determined from a meta-analysis of the data abstracted from the articles.

oMost highlighted Results: 

oAt 2–4 yrs follow up: A significantly higher success rate was found for endodontic surgery: 77.8% vs. 70.9% non surgical.

oAt 4-6 yrs follow up: nonsurgical retreatment showed a higher success rate: 84% vs. 71.8% (surgical).

oAt 6 yrs follow up: only articles of surgical retreatment were available and the success rate decreased to 63%.

oClinical significance: 

It appears that endodontic surgery offers more favorable initial success, but nonsurgical retreatment offers a more favorable long-term outcome.