Outcome of orthograde retreatment after failed apicoectomy

• Verfasst von: Mente, Johannes [VerfasserIn]
• Verfasst von: Leo, Meltem [VerfasserIn]
• Verfasst von: Michel, Annemarie [VerfasserIn]
• Verfasst von: Gehrig, Holger [VerfasserIn]
• Verfasst von: Saure, Daniel [VerfasserIn]
• Verfasst von: Pfefferle, Thorsten [VerfasserIn]
• Titel: Outcome of orthograde retreatment after failed apicoectomy
• Titelzusatz: Use of a mineral trioxide aggregate apical plug
• Verf.angabe: 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
• E-Jahr: 2015
• Jahr: 18 February 2015
• Umfang: 8 S.
• Fussnoten: Gesehen am 18.08.2017
• Titel Quelle: Enthalten in: Journal of endodontics
• Ort Quelle: Amsterdam [u.a.] : Elsevier, 1975
• Jahr Quelle: 2015
• Band/Heft Quelle: 41(2015), 5, Seite 613-620
• ISSN Quelle: 1878-3554
• DOI: doi:10.1016/j.joen.2015.01.002
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: Failed apicoectomy
• Sach-SW: mineral trioxide aggregate
• Sach-SW: orthograde retreatment
• Sach-SW: Treatment Outcome
• K10plus-PPN: 1562488899

Abstract

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.