Surgical versus non-surgical endodontic re-treatment for periradicular lesions.

By Del Fabbro M, Taschieri S, Testori T, Francetti L, Weinstein RL

Date: 06/2007
Journal: Cochrane Database Syst Rev

Summary: 

Purpose: To test if there is a difference in outcome between surgical and non-surgical therapy for endodontic re-treatment of periradicular lesions •n:  3 RCT one with high quality and 2 with moderate quality

•Materials/Methods:

•The Cochrane Oral Health Group Trials Register, CENTRAL, MEDLINE and EMBASE were searched.

•Hand-searching included eight dental journals. The bibliographies of relevant clinical trials and relevant articles were checked.

•Inclusion criteria:

RCTs about re-treatment of teeth with periapical pathosis in which both surgical and non-surgical approaches were used and having a follow up of at least 1 year were considered for the analysis.

•A quality assessment of the included RCTs was carried out and the authors were contacted for missing information.

Most highlighted Results: 

• 3 RCTs were identified.

• In these studies, 126 cases were followed up for at least 1 year, and 82 had a follow up of 4 years.

• At the 1-year follow up the success rate for surgical retreatment was 58%; non-surgical 28%; risk  ratio: 1.13) (Danin 1996)

• When the follow up was extended to 4 years the outcome for the two procedures were similar : 60% (surgical) and 58% (non surgical). (Kvist 1999)

Clinical significance: 

Surgical retreatment results in faster healing compared to non surgical but no difference in long term outcome.