Short-term observation of clinical and radiographic results of periapical microsurgery: a prospective study

The purpose of the present study was to clinically and radiographically evaluate the periapical healing responses of patients with persistent apical periodontitis who were treated with microsurgical techniques and root-end fillings with mineral trioxide aggregate (MTA). Ninety-seven consecutive patients with 128 teeth demonstrating persistent periapical lesions were included in the study. A modern endodontic surgical protocol, which included mucoperiosteal flap elevation, an ostectomy, root-end resection, ultrasonic root-end preparation, and root-end filling with MTA, was performed. One year later, all of the patients were examined clinically and radiographically. Chi-square tests were used to analyze the results. The radiological and clinical evaluations indicated success in 57.7% of the patients, improvement in 35.1%, and failure in 7.2%. No statistically significant differences were found in the treatment results according to sex, age, or tooth type. A statistically significant relationship (P<0.05) was noted between the size and type of lesion and prognosis. The larger lesions and cysts had the worst prognoses. The use of state-of-the-art microscopes, microinstruments, and ultrasonic tips and more biologically acceptable root-end filling materials in strict microsurgical approaches produces better outcomes in patients with persistent apical periodontitis.