Effect of guided tissue regeneration on the outcome of surgical endodontic treatment of through-and-through lesions: a retrospective study at 4-year follow-up

Oral Maxillofac Surg (2011) 15:153159 DOI 10.1007/s10006-011-0272-y

ORIGINAL ARTICLE

Effect of guided tissue regeneration on the outcomeof surgical endodontic treatment of through-and-through lesions: a retrospective study at 4-year follow-up

Silvio Taschieri & Stefano Corbella & Igor Tsesis &

Monica Bortolin & Massimo Del Fabbro

Received: 5 January 2011 /Accepted: 8 April 2011 /Published online: 3 May 2011 # Springer-Verlag 2011

AbstractPurpose The main purpose of this retrospective cohort study was to evaluate the 4-year success rate of endodontic surgery in combination with a collagen resorbable membrane for the treatment of through-and-through periradicular lesions. Materials and methods Patients with one or more teeth with a through-and-through periradicular lesion in need of endodontic surgery were treated. A clinical and radiographic evaluation was performed at 3, 6, 12, 24, 36, and 48 months. The outcome was categorized at 1 and 4-year follow-up as success, failure, and doubtful depending on clinical signs and symptoms and radiographic evaluation. Fisher's exact test was used to evaluate differences between successful and failed cases (P<0.05).

Results Forty-three teeth in 33 patients were radiographically and clinically evaluated after 4 years. Thirty-eight teeth were classified as success, 4 teeth as failure, and 1 tooth as doubtful. No statistically significant differences were found in results related to tooth type, tooth location, and presence of post.

Conclusions The association of endodontic surgery and guided tissue regeneration for the treatment of through-and-through periapical lesions leads to excellent outcomes up to 4 years. Standardized criteria are needed to determine the treatment outcome.

Keywords Endodontic surgery. Guided tissue regeneration . Radiographic evaluation . Healing classification . Through-and-through periapical lesion

Introduction

The major objective of periradicular surgery is to obtain periradicular tissue regeneration, including the formation of a new attachment apparatus by exclusion of any noxious agent within the physical confines of the affected root.

In 1991, Gutmann and Harrison [1] delineated the clinical factors that may influence the prognosis of endodontic surgery. Among questionable tooth-related factors were the amount and location of bone loss [13]. Delays or alterations in healing have been reported when lesion size was greater than 5 mm [2, 4, 5]. Several authors showed that the prognosis for smaller lesions after periradicular surgery is better than the prognosis for larger ones [3, 69]. Rubinstein and Kim...