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Tso KY, Wu YH, Tsai YW, Lin YS, Chiu WC. Endodontic apical surgery with novel endoscope: Three-case series. AUST ENDOD J 2024. [PMID: 38923601 DOI: 10.1111/aej.12869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Revised: 05/15/2024] [Accepted: 06/10/2024] [Indexed: 06/28/2024]
Abstract
Successful apical surgery relies on effective magnification and illumination. In the field of endodontics, the microscope has emerged as the predominant tool for meeting these requirements. The rigid endoscope is also a valuable instrument in apical surgery. This study introduces three cases demonstrating the application of endoscope technology in endodontic apical surgery. The first case employs a soft endoscope for treating an anterior tooth with apical periodontitis, the second integrates an endoscope with new attachments for a premolar, and the third combines an endoscope, attachments and navigation for the lower first molar surgery. It revealed that endoscopes offer certain advantages that are not achievable with microscope-assisted surgery, these cases had a great outcome. In the future, a broader application of endoscopic technology in various procedures is anticipated.
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Affiliation(s)
- Kai-Yun Tso
- Division of Endodontics, Department of Stomatology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Department of Stomatology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Institute of Oral Medicine, School of Dentistry, National Cheng Kung University, Tainan, Taiwan
| | - Yu-Hsueh Wu
- Department of Stomatology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Institute of Oral Medicine, School of Dentistry, National Cheng Kung University, Tainan, Taiwan
| | - Yu-We Tsai
- Department of Stomatology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yu-Sheng Lin
- Department of Mechanical Engineering, Southern Taiwan University of Science and Technology, Tainan, Taiwan
| | - Wei-Chih Chiu
- Division of Endodontics, Department of Stomatology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Department of Stomatology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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Shah PK, El Karim IA, Duncan HF, Nagendrababu V, Chong BS. Outcomes reporting in systematic reviews on surgical endodontics: A scoping review for the development of a core outcome set. Int Endod J 2022; 55:811-832. [PMID: 35553439 DOI: 10.1111/iej.13763] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 05/10/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Evidence-informed decision-making in healthcare relies on the translation of research results to everyday clinical practice. A fundamental requirement is that the validity of any healthcare intervention must be supported by the resultant favourable treatment outcome. Unfortunately, differences in study design and the outcome measures evaluated often make it challenging to synthesise the available research evidence required for secondary research analysis and guideline development. Core outcome sets (COS) are defined as an agreed standardised set of outcomes which should be measured and reported as a minimum in all clinical trials on a specific topic. The benefits of COS include less heterogeneity, a reduction in the risk of reporting bias, ensuring all trials contribute data to facilitate meta-analyses, and given the engagement of key stakeholders, it also increases the chances that clinically-relevant outcomes are identified. The recognition of the need for COS for assessing endodontic treatment outcomes lead to the development of Core Outcome Sets for Endodontic Treatment modalities (COSET) protocol, which is registered (No. 1879) on the Core Outcome Measures in Effectiveness Trials (COMET) website. OBJECTIVES The objectives of this scoping review are to: (1) identify the outcomes assessed in studies evaluating surgical endodontic procedures; (2) report on the method of assessment used to measure the outcomes; (3) and assess selective reporting bias in the included studies. The data obtained will be used to inform the development of COS for surgical endodontics. METHODS A structured literature search of electronic databases and the grey literature was conducted to identify systematic reviews on periradicular surgery (PS), intentional replantation (IR) and tooth/root resection (RR), published between January 1990 and December 2020. Two independent reviewers were involved in the literature selection, data extraction and the appraisal of the studies identified. The type of intervention, outcomes measured, type of outcomes reported (clinician- or patient-reported), outcome measurement method, and follow-up period, were recorded using a standardised form. RESULTS Twenty-six systematic reviews consisting of 19 studies for PS, three studies for IR and four studies for RR were selected for inclusion. Outcome measures identified for PS and IR included pain, swelling, mobility and tenderness, outcomes related to periodontal/soft tissue healing (including sinus tract), periradicular healing, tooth survival, life impact (including Oral-Health-Related-Quality-of-Life), resource use and/or adverse effects. For RR, in addition to tooth survival, endodontic complications, and adverse effects, the outcome measures were primarily periodontal-related, including pocket depth reduction, attachment gain, periodontal disease, and periodontic-endodontic lesions. The majority of outcome measures for PS, IR, and RR were assessed clinically, radiologically and/or via patient history. Specific tools such as rating scales (Visual Analog Scale, Verbal rating Scale, Numerical Rating Scale, and other scales) were used for the assessment of pain, swelling, and tenderness, and validated questionnaires were used for the assessment of oral health-related quality of life. The range of follow-up periods were variable, dependent on the outcome measure and the type of intervention. CONCLUSIONS Outcome measures, method of assessment and follow-up periods for PS, IR and RR were identified and categorised to help standardise the reporting of outcomes for future research studies. Additional outcome measures that were not reported, but may be considered in the COSET consensus process include loss of root-end filling material, number of clinic visits, surgery-related dental anxiety and muco-gingival aesthetic-related measures, such as scarring, black triangles, root surface exposure, and tissue discolouration.
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Affiliation(s)
- Pratik Kamalkant Shah
- Institute of Dentistry, Faculty of Medicine & Dentistry, Queen Mary University of London, London, UK
| | - Ikhlas A El Karim
- School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, Northern Ireland, UK
| | - Henry Fergus Duncan
- Division of Restorative Dentistry & Periodontology, Dublin Dental University Hospital, Trinity College Dublin, Dublin, Ireland
| | - Venkateshbabu Nagendrababu
- Department of Preventive and Restorative Dentistry, College of Dental Medicine, University of Sharjah, Sharjah, UAE
| | - Bun San Chong
- Institute of Dentistry, Faculty of Medicine & Dentistry, Queen Mary University of London, London, UK
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Prognostic Factors in Endodontic Surgery Using an Endoscope: A 1 Year Retrospective Cohort Study. MATERIALS 2022; 15:ma15093353. [PMID: 35591687 PMCID: PMC9103390 DOI: 10.3390/ma15093353] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 04/22/2022] [Accepted: 05/05/2022] [Indexed: 12/12/2022]
Abstract
This retrospective study clarified the success rate of endoscopic endodontic surgeries and identified predictors accounting for successful surgeries. In this retrospective study, 242 patients (90 males, 152 females) who underwent endoscopic endodontic surgery at a single general hospital and were diagnosed through follow-up one year later were included. Risk factors were categorized into attributes, general health, anatomy, and surgery. Then, the correlation coefficient was calculated for the success or failure of endodontic surgery for each variable, the odds ratio was calculated for the upper variable, and factors related to the surgical prognosis factor were identified. The success rate of endodontic surgery was 95.3%, showing that it was a highly predictable treatment. The top three correlation coefficients were post, age, and perilesional sclerotic signs. Among them, the presence of posts was the highest, compared with the odds ratio, which was 9.592. This retrospective study revealed the success rate and risk factors accounting for endoscopic endodontic surgeries. Among the selected clinical variables, the presence of posts was the most decisive risk factor determining the success of endodontic surgeries.
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Impact of Periodontal Attachment Loss on the Outcome of Endodontic Microsurgery: A Systematic Review and Meta-Analysis. MEDICINA-LITHUANIA 2021; 57:medicina57090922. [PMID: 34577845 PMCID: PMC8465214 DOI: 10.3390/medicina57090922] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Revised: 08/27/2021] [Accepted: 08/28/2021] [Indexed: 11/28/2022]
Abstract
Background and Objectives: Endodontic microsurgery (EMS) aims to eradicate the sources of infection once the apical root resection removes most of the infected anatomical structures and repairs potential procedural errors in the apical region. An endodontic-periodontal lesion yields a pathological communication between the pulp and the periodontium. The purpose of this systematic review and meta-analysis is to evaluate the impact of periodontal attachment loss on the outcome of teeth submitted to EMS. Materials and Methods: PRISMA guidelines were followed. An electronic search was performed in EBSCOhost, Embase and PubMed databases with the following search key: (“endodontic microsurgery” AND “outcome”). No filters were used concerning the year of publication or language. Only randomized clinical trials, prospective and retrospective clinical studies in humans, with a minimum one-year follow-up, defined clinical and radiographic outcome criteria and estimable success rate for endodontic-periodontal lesion were included. Statistical analysis was performed using OpenMeta[Analyst] software. Results: Of a total of 113 articles, 34 were selected for full-text reading after duplicates deletion and title and abstract analysis. Thirteen and six studies were included in the systematic review and meta-analysis, respectively. A total of 2775 pooled teeth were submitted to EMS, of which 492 teeth and 4 roots had periodontal involvement. According to the qualitative analysis, success rates of the endodontic-periodontal group ranged from 67.6% to 88.2%. Meta-analysis revealed that the absence of periodontal attachment loss was predictive of a higher likelihood of success with an odds ratio of 3.14. Conclusions: Periodontal attachment loss presents a risk factor for EMS outcome. Although endodontic-periodontal lesions were associated with lower success rates considering a 1 to 10 years follow-up period, long-term successful prognosis following EMS has been reported, therefore presenting a fully valid and viable therapeutic option for the management of this type of lesions.
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Glera-Suarez P, Serra-Pastor B, Peñarrocha-Oltra D, Peñarrocha-Diago M, Gay-Escoda C. Periapical Microsurgery with an Endoscope and Microscope of Two Upper Central Incisors Already Subjected to Periapical Surgery 25 Years Ago. Case Rep Dent 2020; 2020:8885568. [PMID: 33343945 PMCID: PMC7725588 DOI: 10.1155/2020/8885568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 11/25/2020] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION The present clinical case describes periapical microsurgery with an endoscope and microscope in a patient already treated 25 years ago due to persistent periapical disease of the two central upper incisors, restored with poorly adapted crowns. Clinical Case. The first periapical surgery had been performed with silver amalgam as a retrograde filler material, causing grayish staining of the buccal mucosa. Periapical surgery was performed raising a submarginal flap with ostectomy and apicoectomy, retrograde cavity preparation with ultrasound tips, and filling with mineral trioxide aggregate (MTA). After soft tissue healing and complete bone regeneration of the lesion, retreatment of the incisors with a fixed prosthesis was carried out, adopting the biologically oriented preparation technique (BOPT). CONCLUSIONS The described periapical microsurgery approach with magnification and illumination of the surgical field was found to be effective, avoiding the need to extract the two central upper incisors.
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Affiliation(s)
- Pablo Glera-Suarez
- Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, Spain
| | - Blanca Serra-Pastor
- Prosthodontics Unit, Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, Spain
| | - David Peñarrocha-Oltra
- Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, Spain
| | - Miguel Peñarrocha-Diago
- Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, Spain
- IDIBELL Institute, Barcelona, Spain
| | - Cosme Gay-Escoda
- IDIBELL Institute, Barcelona, Spain
- Oral and Maxillofacial Surgery Department, Faculty of Medicine and Health Sciences (School of Dentistry), University of Barcelona, Spain
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Pallarés-Serrano A, Glera-Suarez P, Soto-Peñaloza D, Peñarrocha-Oltra D, von Arx T, Peñarrocha-Diago M. The use of the endoscope in endodontic surgery: A systematic review. J Clin Exp Dent 2020; 12:e972-e978. [PMID: 33154800 PMCID: PMC7600213 DOI: 10.4317/jced.56539] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Accepted: 01/27/2020] [Indexed: 01/08/2023] Open
Abstract
Background A systematic review of clinical studies with at least one year of follow-up was done to assess the success rate of endodontic surgery including endoscopy for magnification and illumination.
Material and Methods Five electronic databases were searched, including MEDLINE (via PubMed), Embase, Web of Science, Scopus and the Cochrane Library of the Cochrane Collabora-tion (CENTRAL). There were no language restrictions, and the search covered the period up to October 2019. The risk of bias was evaluated with the Cochrane Collaboration tool for randomized clinical trials and the ROBINS-I tool for non-randomized studies of inter-ventions.
Results From the 278 initially identified titles, finally 2 randomized controlled trials and 3 non-randomized studies met the inclusion criteria. All the included studies analyzed the success rate of endodontic surgery performed with the help of endoscope for magnifica-tion and illumination. The risk of bias was high for allocation sequence concealment and blinding of participants and personnel in the randomized controlled trials. The nonran-domized studies showed limitations in terms of confounding bias and blinding of outcome assessment. Endodontic surgery with the help of an endoscope is associated with high success rates (88.9-94.9%).
Conclusions The endoscope was associated with high success rates of endodontic sur-gery in the included studies. Future studies on this topic are warranted, due to the meth-odological issues and the scarce number of randomized clinical trials. Key words:Endodontic surgery, magnification, endoscope, success.
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Affiliation(s)
- Antonio Pallarés-Serrano
- DDS, MS. Master in Oral Surgery and Implant Dentistry, Department of Stomatolo-gy, Faculty of Medicine and Dentistry, University of Valencia, Spain
| | - Pablo Glera-Suarez
- DDS. Master in Oral Surgery and Implant Dentistry, Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, Spain
| | - David Soto-Peñaloza
- DDS, MS. Master in Oral Surgery and Implant Dentistry, Department of Stomatolo-gy, Faculty of Medicine and Dentistry, University of Valencia, Spain
| | - David Peñarrocha-Oltra
- DDS, PhD. Assistant Professor, Oral Surgery Unit, Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, Spain
| | - Thomas von Arx
- Prof. Dr. med. dent. Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Miguel Peñarrocha-Diago
- MD, PhD, DDS. Full Professor, Oral Surgery Unit, Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, Spain
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Yasin-Ertem S, Altay H, Hasanoglu-Erbasar N. The evaluation of apicectomy without retrograde filling in terms of lesion size localization and approximation to the anatomic structures. Med Oral Patol Oral Cir Bucal 2019; 24:e265-e270. [PMID: 30818321 PMCID: PMC6441604 DOI: 10.4317/medoral.22834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Accepted: 01/26/2019] [Indexed: 11/05/2022] Open
Abstract
Background The purpose of this study was to evaluate of the patients who underwent apical resection. Besides assess the classification of resection side, localization, lesion size, approximation of anatomic structures and the purpose of the apical surgery retrospectively. Material and Methods In this stutdy 782 patients and 1191 apical resection applied tooth evaluated. 504 of the patients were famale and 278 were male. Patients age was between 13 and 76 years old and operated between January 2016 and January 2017. The study includes incisor, canine and premolar teeth which had the apical resection as the first time. Operation side evaluated from orthopantomograph and periapical radiographs. Results There were 1191 teeth operated and 966 of them in maxilla and 225 of them in mandible. The number of the incisor teeth were 871, 177 were canine, 129 were premolar and one of them was molar. The total amount of 468 patients had operated by just 1 tooth, 454 of the operated teeth had cyst on the operation side. Premolar and molar side 21 of the 93 lesion had approximation with maxillar sinus. On the other hand in maxilla 39 of 569 lesion had approximation with nasal cavity. In mandibula 1 of the 15 lesion, which involved mandibular premolar teeth, had approximation with mental foramen. Conclusions Apical resection operation mostly done for one tooth, and the lesion size was less than 10 milimeters. Furthermore apical resection mostly done for incisors cause of odontogenic cyst. Key words:Apical resection, gender, maxillary sinus, mental foramen, odontogenic cyst.
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Affiliation(s)
- S Yasin-Ertem
- Oral & Maxillofacial Surgery, Department Dentistry, Faculty Ankara Yildirim Beyazit, University Ankara Turkey, Adress: Guclukaya Mah., Fatih Cad Cagla Sok. No:2, 06280 Kecioren,Ankara,
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Assessment of Simultaneous Surgery for Odontogenic Sinusitis: Endoscopic Sinus Surgery With Endoscopic Apicoectomy. J Craniofac Surg 2019; 30:239-243. [PMID: 30444772 DOI: 10.1097/scs.0000000000005134] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Odontogenic sinusitis (OS) is a disease commonly encountered by otolaryngologists and oral surgeons. There is currently no standard consensus for the management of the causative teeth of OS, and the therapeutic outcomes of endodontic surgery remain unclear. The authors herein report the outcomes of simultaneous surgery for OS, endoscopic sinus surgery (ESS) with endoscopic apicoectomy. Twenty-one OS patients who underwent ESS were included in the intent-to-treat population. Eleven patients who simultaneously underwent endoscopic apicoectomy were included as the study group, and another 10 patients who were subjected to the extraction of the causative teeth preceding or during surgery were included as the control group. The postoperative tooth course after surgery in the study group was assessed as the primary outcome by periodic radiographs. The postoperative sinus course was compared between the 2 groups as the secondary outcome. Seventeen teeth were subjected to endoscopic apicoectomy concurrently with ESS, and the treatment success rate for periapical lesions was 94.1% (16 out of 17 teeth), which was consistent with previously reported outcomes for endodontic microsurgery. Ten of 11 patients (90.9%) had good postoperative sinus courses, and the mean wound-healing period of the sinus mucosa was 6.9 ± 3.5 weeks. These results were not significantly different from those obtained for the control group (90% and 6.1 ± 3.2 weeks). This surgical procedure may contribute to the preservation of causative teeth without having an impact on the successful treatment of sinusitis. A comprehensive surgical approach by otolaryngologists and oral surgeons is desirable for the treatment of OS.
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Yoshii S, Fujimoto M, Okuda M, Kitamura C. In Vitro Evaluation of a Novel Root Canal Endoscope for Visualizing the Apex of Curved Root Canal Models and an Extracted Tooth. J Endod 2018; 44:1856-1861. [PMID: 30390969 DOI: 10.1016/j.joen.2018.08.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Revised: 08/20/2018] [Accepted: 08/26/2018] [Indexed: 01/14/2023]
Abstract
INTRODUCTION In straight root canals, intraradicular structures around the root canal orifice and apical foramen can be visualized with a dental operating microscope and commercially available root canal endoscopes. However, the root apex area, including the apical foramen, in a curved root canal cannot be visualized using these devices. In the present study, the potential of a newly developed root canal endoscope implementing an image fiber was examined in 3 types of root canal models and extracted teeth. METHODS A straight and 2 curved (10° and 30°) resin block models were prepared. A resolution chart was set at the outer surface of the apical foramen in each model. Using the microscope and the endoscope, the resolution chart was observed, and the captured images were analyzed quantitatively. Additionally, fracture lines in 20 extracted teeth were observed with both devices. RESULTS With the dental operating microscope, a resolution chart line was clearly observed in the straight canal model with 18.0 line pairs/mm resolution and an observing capability of 0.16 at 40 × magnification but not in the curved root canal models. With the root canal endoscope, resolution charts in all types of root canal models were visualized, and the resolution and observing capability were 16.0 line pairs/mm and 0.053, respectively. Fracture lines and the apical foramen of the extracted teeth were observed more clearly with the endoscope than the microscope. CONCLUSIONS The newly developed root canal endoscope using an image fiber is useful for accurate visualization of the apex area of curved root canals.
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Affiliation(s)
- Shinji Yoshii
- Division of Endodontics and Restorative Dentistry, Department of Oral Functions, Kyushu Dental University, Kitakyushu, Fukuoka, Japan
| | - Masataka Fujimoto
- Division of Endodontics and Restorative Dentistry, Department of Oral Functions, Kyushu Dental University, Kitakyushu, Fukuoka, Japan
| | - Masahiro Okuda
- Department of Information and Media Engineering, Faculty of Environmental Engineering, The University of Kitakyushu, Kitakyushu, Fukuoka, Japan
| | - Chiaki Kitamura
- Division of Endodontics and Restorative Dentistry, Department of Oral Functions, Kyushu Dental University, Kitakyushu, Fukuoka, Japan.
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Outcome of Endodontic Surgery: A Meta-analysis of the Literature-Part 3: Comparison of Endodontic Microsurgical Techniques with 2 Different Root-end Filling Materials. J Endod 2018; 44:923-931. [PMID: 29681480 DOI: 10.1016/j.joen.2018.02.021] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Revised: 02/17/2018] [Accepted: 02/19/2018] [Indexed: 12/12/2022]
Abstract
INTRODUCTION The aim of the present study was to investigate the influence of root-end preparation and filling material on endodontic surgery outcome. A systematic review and meta-analysis was conducted to determine the outcome of resin-based endodontic surgery (RES, the use of high-magnification preparation of a shallow and concave root-end cavity and bonded resin-based root-end filling material) versus endodontic microsurgery (EMS, the use of high-magnification ultrasonic root-end preparation and root-end filling with SuperEBA [Keystone Industries, Gibbstown, NJ], IRM [Dentsply Sirona, York, PA], mineral trioxide aggregate [MTA], or other calcium silicate cements). METHODS An exhaustive literature search was conducted to identify prognostic studies on the outcome of root-end surgery. Human studies conducted from 1966 to the end of December 2016 in 5 different languages (ie, English, French, German, Italian, and Spanish) were searched in 4 electronic databases (ie, Medline, Embase, PubMed, and Cochrane Library). Relevant review articles on the subject were scrutinized for cross-references. In addition, 5 dental and medical journals (Journal of Endodontics; International Endodontic Journal; Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics; Journal of Oral and Maxillofacial Surgery; and International Journal of Oral and Maxillofacial Surgery) were hand checked dating back to 1975. All abstracts were screened by 3 independent reviewers (H.B., M.K., and F.S.). Strict inclusion-exclusion criteria were defined to identify relevant articles. Raw data were extracted from the full-text review of these selected articles independently by each of the 3 reviewers. In case of disagreement, an agreement was reached by discussion, and qualifying articles were assigned to group RES. For EMS, the same search strategy was performed for the time frame October 2009 to December 2016, whereas up to October 2009 the data were obtained from a previous systematic review with identical criteria and search strategy. Weighted pooled success rates and a relative risk assessment between RES and EMS were calculated. To make a comparison between groups, a random effects model was used. RESULTS Sixty-eight articles were eligible for full-text review. Of these, per strict inclusion exclusion criteria, 14 studies qualified, 3 for RES (n = 862) and 11 for EMS (n = 915). Weighted pooled success rates for RES were 82.20% (95% confidence interval [CI], 0.7965-0.8476) and 94.42% for EMS (95% CI, 0.9295-0.9590). This difference was statistically significant (P < .0005). CONCLUSIONS The probability for success for EMS proved to be significantly greater than the probability for success for RES, providing best available evidence on the influence of cavity preparation with ultrasonic tips and/or SuperEBA (Keystone Industries, Gibbstown, NJ), IRM (Dentsply Sirona, York, PA), MTA, or silicate cements as root-end filling material instead of a shallow cavity preparation and placement of a resin-based material. Additional large-scale randomized clinical trials are needed to assess other predictors of outcome.
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Predictors of clinical outcomes in endodontic microsurgery: a systematic review and meta-analysis. GIORNALE ITALIANO DI ENDODONZIA 2017. [DOI: 10.1016/j.gien.2017.03.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Chércoles-Ruiz A, Sánchez-Torres A, Gay-Escoda C. Endodontics, Endodontic Retreatment, and Apical Surgery Versus Tooth Extraction and Implant Placement: A Systematic Review. J Endod 2017; 43:679-686. [DOI: 10.1016/j.joen.2017.01.004] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Revised: 01/01/2017] [Accepted: 01/08/2017] [Indexed: 10/19/2022]
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Clé-Ovejero A, Valmaseda-Castellón E. Haemostatic agents in apical surgery. A systematic review. Med Oral Patol Oral Cir Bucal 2016; 21:e652-7. [PMID: 27475689 PMCID: PMC5005106 DOI: 10.4317/medoral.21109] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2015] [Accepted: 03/20/2016] [Indexed: 11/13/2022] Open
Abstract
Background Blood presence in apical surgery can prevent the correct vision of the surgical field, change the physical properties of filling materials and reduce their sealing ability.
Objetive To describe which are the most effective and safest haemostatic agents to control bleeding in patients undergoing apical surgery. Material and Methods TWe carried out a systematic review, using Medline and Cochrane Library databases, of human clinical studies published in the last 10 years. Results The agents that proved more effective in bleeding control were calcium sulphate (100%) and collagen plus epinephrine (92.9%) followed by ferric sulphate (60%), gauze packing (30%) and collagen (16.7%). When using aluminium chloride (Expasyl®), over 90% of the apical lesions improved, but this agent seemed to increase swelling. Epinephrine with collagen did not significantly raise either blood pressure or heart rate. Conclusions Despite the use of several haemostatic materials in apical surgery, there is little evidence on their effectiveness and safety. The most effective haemostatic agents were calcium sulphate and epinephrine plus collagen. Epinephrine plus collagen did not seem to significantly raise blood pressure or heart rate during surgery. Aluminium chloride did not increase postoperative pain but could slightly increase postoperative swelling. Randomized clinical trials are needed to assess the haemostatic effectiveness and adverse effects of haemostatic materials in apical surgery. Key words:Haemostasis, apical surgery.
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Affiliation(s)
- A Clé-Ovejero
- Faculty of Dentistry - University of Barcelona, Campus de Bellvitge UB, Facultat d'Odontologia, C/ Feixa Llarga, s/n, Pavelló Govern, 2 planta, Despatx 2.9, 08907 L'Hospitalet de Llobregat, Barcelona, Spain,
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Outcome of nonsurgical retreatment and endodontic microsurgery: a meta-analysis. Clin Oral Investig 2015; 19:569-82. [DOI: 10.1007/s00784-015-1398-3] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2014] [Accepted: 01/02/2015] [Indexed: 01/23/2023]
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Tooth Retention through Endodontic Microsurgery or Tooth Replacement Using Single Implants: A Systematic Review of Treatment Outcomes. J Endod 2015; 41:1-10. [DOI: 10.1016/j.joen.2014.09.002] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2014] [Accepted: 09/01/2014] [Indexed: 12/20/2022]
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Tsesis I, Rosen E, Taschieri S, Telishevsky Strauss Y, Ceresoli V, Del Fabbro M. Outcomes of Surgical Endodontic Treatment Performed by a Modern Technique: An Updated Meta-analysis of the Literature. J Endod 2013; 39:332-9. [PMID: 23402503 DOI: 10.1016/j.joen.2012.11.044] [Citation(s) in RCA: 124] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2012] [Revised: 11/21/2012] [Accepted: 11/26/2012] [Indexed: 10/27/2022]
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17
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La gestione dei tessuti molli in chirurgia endodontica. DENTAL CADMOS 2012. [DOI: 10.1016/j.cadmos.2011.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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