Cone-beam computed tomographic images provided a more precise
evaluation of periapical lesions suggests a recent study published in the International
Dental Journal

Endodontic microsurgery (EMS) is a surgical endodontic
retreatment approach characterised by modern microsurgical techniques that
integrate the use of an operating microscope or endoscope, root-end cavity
preparation with ultrasonic tips, and more biocompatible root-end filling
materials such as immediate restorative material, super ethoxy benzoic acid, or
mineral trioxide aggregate.

The overall pooled success rate of EMS is more than 90%. Its
success is usually assessed through radiographic and clinical examinations
during follow-up. In endodontics, conventional periapical radiographs (CPRs)
are commonly used to visualise osseous healing outcomes after EMS.

CPR is the most common radiographic examination for routine
clinical use. Rud’s and Molven’s criteria have been developed as efficacy
diagnostic criteria for 2-dimensional (2D) images.

This study aimed to compare the healing outcomes of
endodontic microsurgery (EMS) using 2-dimensional (2D) and 3-dimensional (3D)
radiographic evaluation in a Chinese population. The prognostic factors of EMS
were identified according to the 2D and 3D healing classifications.

The teeth (n = 82) were studied using 2D and 3D radiographic
examinations. The 2D and 3D healing criteria were used to evaluate the healing
outcome. Prognostic factors were investigated based on healing outcomes. Data
were analysed using SPSS, and P < .05 was considered significant.

Results:

There were significant differences between 2D and 3D healing
outcomes (P = .004). For the 3D images, age older than 45 years was found to be
a significant negative predictor (P = .005).

Cone-beam computed tomographic images provided more precise
evaluation of periapical lesions and healing outcomes of EMS than conventional
periapical radiographs. Age (>45 years) of the patients exhibited a
significant influence on the healing outcome of EMS as determined using 3D
images.

Reference:

Chaonan Su, Rui Zhang, Rong Wang, Chengcan Yang, Zan Wang,
Liuyan Meng. Prognostic Predictors of Endodontic Microsurgery: Radiographic
Assessment, International Dental Journal, Volume 72, Issue 5, 2022, Pages
628-633, ISSN 0020-6539, https://doi.org/10.1016/j.identj.2022.02.007.

Keywords:

Endodontic microsurgery, Prognostic factors, Cone-beam, computerised
tomography, Chaonan Su, Rui Zhang, Rong Wang, Chengcan Yang, Zan Wang, Liuyan
Meng, International Dental Journal

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