(PR39) Outcome of Endodontic Microsurgery: Success and Survival Rates at Virginia Commonwealth University

Abstract:

Introduction: Endodontic microsurgery treatment is an option for teeth with apical periodontitis and may be indicated for teeth with previous endodontic treatment that have not healed, teeth with canal obstructions which would impede a non-surgical approach, and where a biopsy is needed. The purpose of this study is to evaluate healing after endodontic microsurgery in 2-dimensional PA radiograph and 3 dimensional CBCT imaging.

Methods: Patient records were pooled from graduate resident cases completed at Virginia Commonwealth University in the Graduate Endodontic Clinic between the years 2010 to 2020. Cases were identified using the CDT codes and a key word search within the patient record data base. Eighty-seven teeth were identified and met the criteria with a minimum follow up of 6 months. All patients had a PA radiograph and CBCT imaging before the procedure and PA radiograph immediately after the surgery. Of those 87 teeth, 30 cases had a CBCT imaging with a minimum of 6 month after the procedure. Outcome types were divided into three categories, healed, healing and failure, based on clinical and radiographic evaluation by the examiners. Result: The overall success rate was 92% for periapical (PA) evaluation and 86% for CBCT evaluation.

Conclusion: Endodontic microsurgery is an effective and a predictable procedure with a successful outcome when used in appropriate cases. Multiple factors improve the success such as using a high-power magnification and ultrasonics, a smaller osteotomy, and using biocompatible materials.