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Title: Long-Term Prognosis of Endodontic Microsurgery-A Systematic Review and Meta-Analysis
Authors: Pinto, Diogo 
Marques, Andréa
Pereira, Joana F. 
Palma, Paulo J. 
Santos, João Miguel 
Keywords: endodontic microsurgery; endoscope; root canal therapy; systematic review; surgical endodontic retreatment; survival rate; treatment outcome
Issue Date: 3-Sep-2020
Publisher: MDPI
Serial title, monograph or event: Medicina (Lithuania)
Volume: 56
Issue: 9
Abstract: Background and objectives: The long-term outcome of endodontic microsurgery (EMS) performed on root-filled teeth affected by post-treatment apical periodontitis (AP) has been a matter of debate, re-launched by the introduction of novel root-end filling materials which have been proven to improve the short-term outcome of EMS. The purpose of this systematic review and meta-analysis is to evaluate the clinical and radiographic long-term outcome of endodontic microsurgery in teeth diagnosed with secondary AP through radiographic evaluation. Materials and Methods: This systematic review and meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Inclusion and exclusion criteria were defined a priori to select the best longitudinal evidence. Only randomized clinical trials (RCT) and prospective clinical studies (PCS), with a follow-up ≥ 2-year, and exhibiting well-established clinical and radiographic outcome criteria, were selected. Results: A total of 573 articles were obtained, from which 10 fulfill inclusion criteria: 6 PCS and 4 RCT. Meta-analysis showed a pooled proportion of success rate of 91.3%, from an overall amount of 453 treated teeth included in RCT; from overall 839 included teeth in PCS, a pooled success rate of 78.4% was observed, with the follow-up time ranging from 2 to 13-years. Survival rate outcomes varied from 79 to 100% for the same follow-up period. Five prognostic factors with influence on the outcome were disclosed: smoking habits, tooth location and type, absence/presence of dentinal defects, interproximal bone level, and root-end filling material. Conclusions: High success rates and predictable results can be expected when EMS is performed by trained endodontists, allowing good prognosis and preservation of teeth affected by secondary AP.
ISSN: 1648-9144
DOI: 10.3390/medicina56090447
Rights: openAccess
Appears in Collections:FMUC Med. Dentária - Artigos em Revistas Internacionais
FMUC Medicina - Artigos em Revistas Internacionais

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