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A 10-year Follow-up Study of 119 Teeth Treated with Apical Surgery and Root-end Filling with Mineral Trioxide Aggregate

Published:March 01, 2019DOI:https://doi.org/10.1016/j.joen.2018.12.015

      Abstract

      Introduction

      The objective of this clinical study was to assess the long-term outcome (clinical signs/symptoms and radiographic healing) of teeth treated with apical surgery and mineral trioxide aggregate (MTA) for root-end filling.

      Methods

      One hundred ninety-five patients were recalled 1, 5, and 10 years after apical surgery for clinical and radiographic examinations. Three calibrated observers evaluated the periapical radiographs independently. The evolution of the cases over time was analyzed. Healing classification of teeth was divided into “healed” versus “not healed” teeth using well-established clinical and radiographic healing criteria. The potential influence of sex, age, type of treated tooth, type of MTA, and first-time versus repeat surgery on healing outcome was statistically analyzed.

      Results

      The inception cohort included 195 teeth. The dropout rate after 10 years amounted to 39% (n = 76). Of the 119 teeth available for the 10-year analysis, 97 teeth were classified as healed (81.5%). No significant differences were found with regard to the rate of healed cases for the subcategories of the parameters of age, sex, type of MTA, and first-time or repeat surgery. Concerning the type of treated tooth, the rate of healed maxillary molars (95.2%) differed significantly (P = .035) from the rate of healed maxillary premolars (66.7%). The predictive value of the cases classified as healed at 1 year and remaining so over the 10-year observation period was 86.8%.

      Conclusions

      This 10-year follow-up study of teeth treated with apical surgery and MTA as root-end filling material showed an acceptable rate of healed cases. Many of the lost teeth had been extracted because of longitudinal root fractures during the observation period.

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      References

        • Christiansen R.
        • Kirkevang L.L.
        • Hørstad-Bindslev P.
        • et al.
        Randomized clinical trial of root-end resection followed by root-end filling with mineral trioxide aggregate or smoothing of the orthograde gutta-percha root filling – 1-year follow-up.
        Int Endod J. 2009; 42: 105-114
        • Torabinejad M.
        • Hong C.U.
        • McDonald F.
        • et al.
        Physical and chemical properties of a new root-end filling material.
        J Endod. 1995; 21: 349-353
        • Torabinejad M.
        • Hong C.U.
        • Lee S.J.
        • et al.
        Investigation of mineral trioxide aggregate for root-end filling in dogs.
        J Endod. 1995; 21: 603-608
        • Torabinejad M.
        • Pitt Ford T.R.
        • McKendry D.J.
        • et al.
        Histologic assessment of mineral trioxide aggregate as a root-end filling in monkeys.
        J Endod. 1997; 23: 225-228
        • Baek S.H.
        • Plenk H.
        • Kim S.
        Periapical tissue responses and cementum regeneration with amalgam, Super EBA, and MTA as root-end filling materials.
        J Endod. 2005; 31: 444-449
        • Katsamakis S.
        • Slot D.E.
        • van der Sluis L.W.
        • van der Weijden F.
        Histological responses of the periodontium to MTA: a systematic review.
        J Clin Periodontol. 2013; 40: 334-344
        • von Arx T.
        • White S.N.
        Outcomes of endodontic surgery.
        in: Torabinejad M. Rubinstein R. The Art and Science of Contemporary Surgical Endodontics. 1st ed. Quintessence Publishing, Hanover Park, IL2017: 297-314
        • Kruse C.
        • Spin-Neto R.
        • Christiansen R.
        • et al.
        Periapical bone healing after apicectomy with and without retrograde root filling with mineral trioxide aggregate: a 6-year follow-up of a randomized controlled trial.
        J Endod. 2016; 42: 533-537
        • European Society of Endodontology
        Quality guidelines for endodontic treatment: Consensus report of the European Society of Endodontology.
        Int Endod J. 2006; 39: 921-930
        • Maloney W.J.
        • Weinberg M.A.
        Implementation of the American Society of Anesthesiologists physical status classification system in periodontal practice.
        J Periodontol. 2008; 79: 1124-1126
        • Rud J.
        • Andreasen J.O.
        • Jensen J.E.
        Radiographic criteria for the assessment of healing after endodontic surgery.
        Int J Oral Surg. 1972; 1: 195-214
        • Molven O.
        • Halse A.
        • Grung B.
        Observer strategy and the radiographic classification of healing after endodontic surgery.
        Int J Oral Maxillofac Surg. 1987; 16: 432-439
        • von Arx T.
        • Penarrocha M.
        • Jensen S.S.
        Prognostic factors in apical surgery with root-end filling: a meta-analysis.
        J Endod. 2010; 36: 957-973
        • Altman D.G.
        Practical Statistics for Medical Research.
        1st ed. Chapman and Hall, London, UK1991
        • Christiansen R.
        • Kirkewang L.L.
        • Gotfredsen E.
        • et al.
        Periapical radiography and cone beam computed tomography for assessment of the periapical bone defect 1 week and 12 months after root-end resection.
        Dentomaxillofac Radiol. 2009; 38: 531-536
        • von Arx T.
        • Janner S.F.
        • Hänni S.
        • et al.
        Agreement between 2D and 3D radiographic outcome assessment one year after periapical surgery.
        Int Endod J. 2016; 49: 915-925
        • Curtis D.M.
        • van der Weele R.A.
        • Ray J.J.
        • Wealleans J.A.
        Clinician-centered outcomes assessment of retreatment and endodontic microsurgery using cone-beam computed tomographic volumetric analysis.
        J Endod. 2018; 44: 1251-1256
        • Bornstein M.M.
        • Yeung A.W.
        • Tanaka R.
        • et al.
        Evaluation of health or pathology of bilateral maxillary sinuses in patients referred for cone beam computed tomography using a low-dose protocol.
        Int J Periodontics Restorative Dent. 2018; 38: 699-710
        • Tortorci S.
        • Difalco P.
        • Caradonna L.
        • et al.
        Traditional endodontic surgery versus modern technique: a 5-year controlled clinical trial.
        J Craniofac Surg. 2014; 25: 804-807
        • Song M.
        • Chung W.
        • Lee S.J.
        • et al.
        Long-term outcome of the cases classified as successes based on short-term follow-up in endodontic microsurgery.
        J Endod. 2012; 38: 1192-1196
        • Song M.
        • Nam T.
        • Shin S.J.
        • et al.
        Comparison of clinical outcomes of endodontic microsurgery: 1 year versus long-term follow-up.
        J Endod. 2014; 40: 490-494
        • von Arx T.
        • Hänni S.
        • Jensen S.S.
        5-year results comparing MTA and adhesive resin composite for root-end sealing in apical surgery.
        J Endod. 2014; 40: 1077-1081
        • Yazdi P.M.
        • Schou S.
        • Jensen S.S.
        • et al.
        Dentine-bonded resin composite (Retroplast) for root-end filling: a prospective clinical and radiographic study with a mean follow-up of 8 years.
        Int Endod J. 2007; 40: 493-503
        • Barone C.
        • Dao T.T.
        • Basrani B.B.
        • et al.
        Treatment outcome in endodontics: the Toronto study – phases 3, 4, and 5: apical surgery.
        J Endod. 2010; 36: 28-35
        • Tawil P.Z.
        • Saraiya V.M.
        • Galicia J.C.
        • et al.
        Periapical microsurgery: the effect of root dentinal defects on short- and long-term outcome.
        J Endod. 2015; 41: 22-27