RESUMO
OBJECTIVE: To evaluate the effect of patient- and tooth-related factors on the outcome of apical surgery in a multicenter study. METHOD AND MATERIALS: A total of 281 teeth in 255 patients undergoing periradicular surgery were investigated clinically and radiographically 6 to 12 months postoperatively. RESULTS: The overall success rate was 88.0%. Sex was a significant (P = .024) predictor, with a success rate of 89.8% in females and 84.0% in males. The success rate was significantly higher in patients 31 to 40 years of age. The treatment of premolars resulted in a significantly higher success rate (91.9%) than the treatment of anterior teeth (86.1%, P = .042) and molars (86.4 %, P = .026). The loss of the buccal bone plate and the extension of apical osteolysis to the furcation area in molars resulted in a considerably lower success rate. Lesion size, preoperative pain, tenderness to percussion, fistula, and resurgery were significant factors. CONCLUSION: There are several factors influencing the success rate of apical surgery that must be taken into account when considering apical surgery as a treatment alternative.
Assuntos
Apicectomia/métodos , Doenças Periapicais/cirurgia , Adulto , Fatores Etários , Perda do Osso Alveolar/complicações , Perda do Osso Alveolar/cirurgia , Apicectomia/instrumentação , Dente Pré-Molar/cirurgia , Regeneração Óssea/fisiologia , Dente Canino/cirurgia , Fístula Dentária/complicações , Fístula Dentária/cirurgia , Feminino , Seguimentos , Defeitos da Furca/complicações , Defeitos da Furca/cirurgia , Humanos , Incisivo/cirurgia , Masculino , Pessoa de Meia-Idade , Dente Molar/cirurgia , Osteólise/complicações , Osteólise/cirurgia , Doenças Periapicais/complicações , Complicações Pós-Operatórias , Estudos Prospectivos , Radiografia Dentária Digital , Reoperação , Obturação Retrógrada/métodos , Materiais Restauradores do Canal Radicular/uso terapêutico , Fatores Sexuais , Resultado do TratamentoRESUMO
The authors evaluated periodontal parameters following apical surgery using a new marginal sulcular incision. In 65 cases, surgical access was achieved by means of a sulcular incision technique without the involvement of the adjacent periodontia and the interproximal papillae and in 33 cases by means of a submarginal trapezoidal technique. Periodontal parameters (probing pocket depth, gingival recession, clinical attachment loss, and tooth mobility [periotest]) were recorded at baseline and after 6 months. Scar formation and the loss of papilla height were evaluated photographically. No significant changes in the attachment level and no loss of papilla height were found in either group. A slight gingival recession (0.2 +/- 0.4 mm) corresponding to the decrease in pocket depths occurred on the buccal aspect with the sulcular incision. Tooth mobility was significantly increased in both groups immediately and 6 months after surgery. Scar formation was more unfavorable with the submarginal incision.