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Objectives: To evaluate treatment outcomes and prognostic factors on the success of periapical microsurgery.
Materials and Methods: Patients who were treated with periapical microsurgery at Endodontic Clinic of Dental Hospital and Endodontic Clinic of Golden Jubilee Medical Center, Faculty of Dentistry, Mahidol University, Thailand, from January 2005 to December 2015, were recruited. The outcomes were assessed clinically and radiographically with a recall period of at least one year after the endodontic microsurgery. All radiographic images were scanned and analysed using Image J software, to measure sizes of periapical radiolucency. Modified Friedman’s criteria was employed to classify the outcome as healed, healing, or disease. Pre-operative, intra-operative, and post-operative factors were taken into consideration, and analysed using logistic regression in order to identify any significant factors.
Results: Of all 175 teeth in 154 patients, one-hundred and twenty-nine teeth were recruited. The recall rate was 83.7%(108 teeth) with a mean recall period of 30.8 months(ranging from 12 to 108 months). The outcomes were 86 teeth healed (79.6%), 20 teeth healing (18.5%) and2 teeth diseased (1.9%). Multivariate logistic regression analysis showed that quality of the pre-operative root canal filling was a significant prognostic factor (P<0.05). Teeth with inadequate root canal fillings had six times higher chance of ‘disease’ than teeth with adequate quality fillings.
Conclusion: The healed rate in this study was 79.6%. Inadequate quality of pre-operative root canal filling was the significant negative prognostic factor of the outcomes.
Keywords:endodontic microsurgery, prognostic factors, retrospective study, root-end filling, success and failure, treatment outcome.
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