Outcome of orthograde retreatment after failed apicoectomy: Use of a mineral trioxide aggregate apical plug
This controlled, single-center historic cohort study project evaluates treatment outcomes of a nonsurgical treatment approach after failed apicoectomy. The treatment outcomes of nonsurgical retreatment after a failed apicoectomy were evaluated clinically and radiographically. The study cohort consis...
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| Main Authors: | , , , , , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
18 February 2015
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| In: |
Journal of endodontics
Year: 2015, Volume: 41, Issue: 5, Pages: 613-620 |
| ISSN: | 1878-3554 |
| DOI: | 10.1016/j.joen.2015.01.002 |
| Online Access: | Verlag, Volltext: http://dx.doi.org/10.1016/j.joen.2015.01.002 Verlag, Volltext: http://www.sciencedirect.com/science/article/pii/S0099239915000114 
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| Author Notes: | Johannes Mente, Priv-Doz, Dr med dent, Meltem Leo, Dr med dent, Annemarie Michel, Dr med dent, Holger Gehrig, Dr med dent, MSc, Daniel Saure, MSc, and Thorsten Pfefferle, Dr med dent |
| Summary: | This controlled, single-center historic cohort study project evaluates treatment outcomes of a nonsurgical treatment approach after failed apicoectomy. The treatment outcomes of nonsurgical retreatment after a failed apicoectomy were evaluated clinically and radiographically. The study cohort consisted of teeth that had received primary root canal treatment and subsequent apicoectomy elsewhere before the patients presented with post-treatment disease. Orthograde retreatment and obturation using an apical mineral trioxide aggregate plug was performed by postgraduate students and endodontic specialists in 25 cases between 2004 and 2012. Pre-, intra-, and postoperative information and the potential effect on the retreatment outcome were evaluated and statistically analyzed using the chi-square test. Twenty-two patients with 23 teeth attended the follow-up examinations (recall rate = 92%). The follow-up periods ranged from 12 to 102 months (median = 35 months). Twenty teeth (87%) were classified as “success,” and 3 teeth were considered (17%) “failure.” The chi-square test confirmed that the preoperative factor “number of roots” had a statistically significant effect on treatment outcome (odds ratio = 0.08; 95% confidence interval, 0-1.76; P = .03). The factor “tooth location” was of borderline significance (odds ratio = 0.1; 95% confidence interval, 0-2.14; P = .05). The results of the present study suggest that orthograde retreatment combined with orthograde placement of an apical mineral trioxide aggregate plug is a promising long-term treatment option for teeth with postsurgical pathosis. The success rates were higher for single-rooted teeth. The use of cone-beam computed tomographic imaging in cases of inconclusive periapical radiographs is recommended to minimize the risk of misinterpretation when assessing treatment outcome. |
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| Item Description: | Gesehen am 18.08.2017 |
| Physical Description: | Online Resource |
| ISSN: | 1878-3554 |
| DOI: | 10.1016/j.joen.2015.01.002 |