ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title Endodontic Microsurgery has Higher Success Rate Than Traditional Endodontic Surgery
Clinical Question In teeth requiring root end surgery, does endodontic microsurgery have a higher success rate compared to traditional root end surgery?
Clinical Bottom Line Endodontic microsurgery has a greater success rate compared to traditional root end surgery.
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 20951283Setzer/201021 studies were included (12 TRS and 9 EMS)Meta-analysis of non-randomized longitudinal studies
Key resultsThe weighted pooled success rate for the traditional root end surgery group was 59% and for the endodontic microsurgery group was 94%. Differences between the groups were statistically significant (z = 31.84, standard error = 0.0232, P < 0.0005).
Evidence Search “Endodontic microsurgery” (all fields) or “Traditional root end surgery”(all fields)
Comments on
The Evidence
Validity: 3 electronic databases in 5 different languages and 5 journals were hand searched. Three independent reviewers assessed the articles and 21 studies were included in this meta- analysis. These studies were categorized according the type/quality of research study. Raw data was extracted from the studies that were included, and the data were transferred to custom-designed data acquisition spreadsheets and subjected to statistical analysis. This review addresses a clearly focused issue and hence, the materials and methods are valid. Perspective: The endodontic microsurgery technique utilizes greater magnification and bio- cements such as MTA, which results in a higher success rate. It is necessary that general practitioners are aware of such advancements in technology as this affects the treatment approach. This meta-analysis, although very strong, does not include any randomized clinical trials that have direct comparisons between the endodontic microsurgery and traditional root end surgery as no RCTs have been undertaken
Applicability The success rates for endodontic microsurgery are comparable to primary endodontic treatment without periapical pathology (Ng et al, 2007) and extraction and implant (Iqbal and Kim, 2007). As Setzer and Kim (2013) stated, “…a missing tooth is irreversibly gone. There is no lifetime guarantee for either a natural tooth or an implant.” General practitioners need to be aware and appropriately counsel their patients that with Modern Endodontic Surgical techniques, retention of the natural tooth may be the treatment of choice. Endodontic microsurgery is also usually less expensive, less time consuming, and less invasive than extraction and implant.
Specialty/Discipline (Endodontics) (General Dentistry)
Keywords Apicoectomy, Endodontic microsurgery, Meta-analysis, Root end surgery, Systematic review, Retrograde surgery, Peri-radicular surgery
ID# 2798
Date of submission: 12/07/2014spacer
E-mail priyanka.joshi@ucdenver.edu
Author Priyanka Joshi
Co-author(s)
Co-author(s) e-mail
Faculty mentor/Co-author Ethelyn Thomason, DMD
Faculty mentor/Co-author e-mail ETHELYN.THOMASONLARSEN@UCDENVER.EDU
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?)
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Comments on the CAT
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