A prospective clinical study of polycarboxylate cement in periapical surgery

Objective: To evaluate the clinical efficacy of polycarboxylate cement as retrograde filling material. Design: A prospective clinical study was made of 25 patients subjected to periapical surgery with ultrasound and magnifying loupes, in which polycarboxylate cement was used as retrograde filling material. Measurements were made of the area and diameter of the lesions pre- and postoperatively, and 6 and 12 months after the operation. The apical resection and retrograde filling areas were also measured, and the prognosis following surgery was recorded. Results: A total of 23 patients with 31 apicoectomized teeth were studied (2 patients being lost to follow-up). The mean area of the periapical lesions before surgery was 52.25 mm2, with a mean major diameter of 6.1 mm and a mean lesser diameter of 4.8 mm. The success rate after 12 months was 54.7%, according to the criteria of VonArx and Kurt. The prognosis was poorer in females, in larger lesions, and in cases with larger retrograde fillingareas. Conclusions: Polycarboxylate cement offers good results, with important bone regeneration after periapical surgery (AU)

Ostectomy versus osteotomy with repositioning of the vestibular cortical inperiapical surgery of mandibular molars: A preliminary study

Introduction: Accessing the tooth roots in periapical surgery (PS) requires the elimination of periapical bone.Objective: To compare the postoperative morbidity and prognosis following PS on mandibular molars by ostectomy,or by osteotomy with repositioning of the vestibular cortical.Material and Methods: A retrospective clinical study of mandibular molars subjected to PS with ultrasound. Two groups were considered according to the surgical procedure used to access the roots: Group 1 (G1) with ostectomy and Group 2 (G2) with osteotomy and repositioning of the vestibular cortical. Only patients who had properly followed the post-operative instructions, adequately completed the post-operative questionnaires, and with a minimum of 12 months follow-up were included in the study. Post-operative morbidity was evaluated, and a clinical and radiographic follow-up was carried out using the criteria established by von Arx and Kurt in 1999. The SPSSprogram version 15 for Windows was used, considering values of p¡Ü0.05 as statistically significant.Results: Seventy-five patients, including 18 men and 57 women, with 87 mandibular molars and 107 periapical lesions were subjected to PS. The mean age of the patients was 38.5 years old (range 15 ¨C 74 years old). The patients were monitored for an average of 27.2 months (range 12 ¨C 120 months). Sixty-six patients (78 teeth) were treatedin G1, and 9 patients (9 teeth) in G2. There was no relationship between the size of the ostectomy and pain, swellingor prognosis (p>0.05). Patients who underwent ostectomy presented more swelling than those subjected to (..) (AU)

Ostectomy versus osteotomy with repositioning of the vestibular cortical in periapical surgery of mandibular molars: a preliminary study.

INTRODUCTION: Accessing the tooth roots in periapical surgery (PS) requires the elimination of periapical bone. OBJECTIVE: To compare the postoperative morbidity and prognosis following PS on mandibular molars by ostectomy, or by osteotomy with repositioning of the vestibular cortical. MATERIAL AND METHODS: A retrospective clinical study of mandibular molars subjected to PS with ultrasound. Two groups were considered according to the surgical procedure used to access the roots: Group 1 (G1) with ostectomy and Group 2 (G2) with osteotomy and repositioning of the vestibular cortical. Only patients who had properly followed the post-operative instructions, adequately completed the post-operative questionnaires, and with a minimum of 12 months follow-up were included in the study. Post-operative morbidity was evaluated, and a clinical and radiographic follow-up was carried out using the criteria established by von Arx and Kurt in 1999. The SPSS program version 15 for Windows was used, considering values of p < or =0.05 as statistically significant. RESULTS: Seventy-five patients, including 18 men and 57 women, with 87 mandibular molars and 107 periapical lesions were subjected to PS. The mean age of the patients was 38.5 years old (range 15-74 years old). The patients were monitored for an average of 27.2 months (range 12-120 months). Sixty-six patients (78 teeth) were treated in G1, and 9 patients (9 teeth) in G2. There was no relationship between the size of the ostectomy and pain, swelling or prognosis (p>0.05). Patients who underwent ostectomy presented more swelling than those subjected to osteotomy (p<0.05). There was no relationship between prognosis and the variables studied (p>0.05). CONCLUSIONS: There was no statistically significant relationship between the surgical procedure used and post-operative pain or prognosis. Patients who underwent an ostectomy presented more swelling than those who were treated with an osteotomy and repositioning of the vestibular cortical.

Radiographic morphometric study of 37 periapical lesions in 30 patients: validation of success criteria.

PURPOSE: The purpose of this study was to establish the midterm prognosis of periapical surgery by use of the ultrasound technique, comparing a scale obtained by image analysis with the success rates according to other prognostic scales. MATERIALS AND METHODS: A clinical follow-up study was performed between September 2004 and September 2005. Thirty-six patients with chronic periapical lesions were treated with periapical surgery via the ultrasound technique and root-end filling with silver amalgam. Evolution was analyzed by use of the different currently accepted assessment scales at 6 and 12 months after intervention with a scale obtained by radiographic image analysis. RESULTS: Thirty patients with a mean age of 40.5 years were studied. The mean follow-up period was 14.2 months. Thirty-seven lesions were analyzed. A positive correlation at 6 months was observed between the radiographic scale proposed in this study and the scales of Rud and Andreasen and von Arx et al. At 12 months, the proposed radiographic scale only correlated with the functional tooth concept established by Friedman. CONCLUSIONS: There was no statistically significant relation between the radiographic scale from the image analyzer and the criteria of Rud and Andreasen and von Arx et al.

Evaluation of healing criteria for success after periapical surgery

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Introduction: In periapical surgery, the absence of standardization between different studies makes it difficult to compare the outcomes.Objective: To compare the healing classification of different authors and evaluate the prognostic criteria of periapical surgery at 12 months.Material and methods: 278 patients (101 men and 177 women) with a mean age of 38.1 years (range 11 to 77) treated with periapical surgery using the ultrasound technique and a 2.6x magnifying glass, and silver amalgam as root-end filling material were included in the study. Evolution was analyzed using the clinical criteria of Mikkonen et al., 1983; radiographic criteria of Rud et al., 1972; the overall combined clinical and radiographic criteria of von Arx and Kurt, 1999; and the Friedman (2005) concept of functional tooth at 12 months of surgery.Results: After 12 months, 87.2% clinical success was obtained according to the Mikkonen et al., 1983 criteria; 73.9% complete radiographic healing using Rud et al. criteria; 62.1% overall success, following the clinical and radiographic parameters of von Arx and Kurt, and 91.9% of teeth were functional. The von Arx and Kurt criteria was found to be the most reliable.Conclusion: Overall evolution according to von Arx and Kurt agreed most closely with the other scales (AU)

Evaluation of healing criteria for success after periapical surgery.

INTRODUCTION: In periapical surgery, the absence of standardization between different studies makes it difficult to compare the outcomes. OBJECTIVE: To compare the healing classification of different authors and evaluate the prognostic criteria of periapical surgery at 12 months. MATERIAL AND METHODS: 278 patients (101 men and 177 women) with a mean age of 38.1 years (range 11 to 77) treated with periapical surgery using the ultrasound technique and a 2.6x magnifying glass, and silver amalgam as root-end filling material were included in the study. Evolution was analyzed using the clinical criteria of Mikkonen et al., 1983; radiographic criteria of Rud et al., 1972; the overall combined clinical and radiographic criteria of von Arx and Kurt, 1999; and the Friedman (2005) concept of functional tooth at 12 months of surgery. RESULTS: After 12 months, 87.2% clinical success was obtained according to the Mikkonen et al., 1983 criteria; 73.9% complete radiographic healing using Rud et al. criteria; 62.1% overall success, following the clinical and radiographic parameters of von Arx and Kurt, and 91.9% of teeth were functional. The von Arx and Kurt criteria was found to be the most reliable. CONCLUSION: Overall evolution according to von Arx and Kurt agreed most closely with the other scales.