Retrospective evaluation of clinical outcome of periapical surgery in endodontic and oral surgery units of a dental hospital

Abstract

Background
Periapical surgery is a critical intervention in the management of persistent periapical pathologies when conventional endodontic treatments fail. This retrospective study aims to evaluate the clinical outcomes of periapical surgeries performed in the Endodontic and Oral Surgery units of a dental hospital, highlighting success rates and influencing factors.

Materials and Methods

The study retrospectively analyzed records of 150 patients who underwent periapical surgery between January 2018 and December 2023. Data were collected on patient demographics, type of lesion, surgical technique, materials used (root-end filling and sealing agents), and post-operative follow-ups at 6 months and 12 months. Outcome measures included resolution of symptoms, radiographic evidence of healing, and recurrence of lesions. Statistical analysis was conducted using chi-square and logistic regression tests to assess factors influencing surgical success.

Results
Among the 150 cases, 120 (80%) demonstrated complete radiographic healing at the 12-month follow-up. Partial healing was observed in 20 cases (13.3%), and 10 cases (6.7%) showed persistent or recurrent lesions. The use of bioceramic materials as root-end filling was associated with a significantly higher success rate (90%) compared to amalgam (70%) and glass ionomer cement (75%) (p < 0.05). Patient factors such as age and systemic health conditions influenced healing outcomes, with younger patients showing better prognosis.

Conclusion
Periapical surgery is an effective treatment for managing periapical pathologies, with a high success rate when advanced materials and techniques are employed. Bioceramic materials significantly enhance surgical outcomes. Patient-specific factors should be considered to optimize success rates. Further prospective studies are recommended for more robust evidence.