ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title Clinical Success of Endodontic Microsurgery at 1 Year Is Predictive of Long Term Success
Clinical Question In endodontic microsurgery, is a 4 year follow up compared to a 1 year follow up more predictive of clinical success?
Clinical Bottom Line Clinical success of endodontic microsurgery at 1 year is predictive of long-term success. Previous studies indicating that the success of endodontic apical surgery decreases over time considered traditional techniques (bur, amalgam, no magnification) that are no longer used today. Several recent case series and a RCT indicate that modern endodontic microsurgery classified as clinically successful at 1 year will remain successful in a long-term follow-up.
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) 24666897Song/2014115 patients undergoing endodontic microsurgery using modern surgical techniques from February 2004–December 2007 Case series
Key resultsThe success rate of endodontic microsurgery at the 4-year follow-up (87.8%) was not significantly different than the success rate observed at the 1-year follow-up (91.3%), P = .344. Clinical success was defined as the absence of clinical signs and symptoms and radiographic evidence of complete or incomplete healing.
#2) 27215809Kim/2016153 patients undergoing modern endodontic microsurgery that were available for both 1 and 4 year follow-up Randomized Controlled Trial
Key resultsThe success rate of endodontic microsurgery at the 4-year follow-up (89.5%) was not significantly different than the observed success rate at the 1-year follow-up (94.3%), P=.063. Clinical success was defined as the absence of clinical signs and symptoms and radiographic evidence of complete or incomplete healing.
#3) 12026924 Rubinstein/200259 roots from 52 patients undergoing modern endodontic microsurgery that were available for follow up at 1 and 4 yearsCase series
Key resultsOf the cases considered successful at 1-year follow-up, 91.5% of those cases remained successful at a 5- to 7-year follow-up. Clinical success was defined a functional, asymptomatic tooth with restoration of the lamina dura or healing by scar formation.
Evidence Search (Endodontic[All Fields] AND ("microsurgery"[MeSH Terms] OR "microsurgery"[All Fields])) AND (Follow[All Fields] AND up[All Fields]) AND (Clinical[All Fields] AND Success[All Fields])
Comments on
The Evidence
Two of the three references were case series analyses. All references point towards the same conclusion, but a systematic review and meta-analysis would be a valuable addition to the endodontic literature. Two of the three references used the same criteria for success while one used similar but separate criteria.
Applicability In immunocompetent patients, endodontic microsurgery classified as successful at a 1-year follow up can be expected to remain successful long term and does not require further follow-up. This evidence can help clinicians and patients avoid some of the difficulty associated with long-term follow-up.
Specialty/Discipline (Endodontics)
Keywords Endodontic Microsurgery, Follow up, Clinical Success
ID# 3101
Date of submission: 11/01/2016spacer
E-mail RitterC@uthscsa.edu
Author Cameron Ritter
Co-author(s)
Co-author(s) e-mail
Faculty mentor/Co-author Nikita Ruparel, DDS, MS, PhD
Faculty mentor/Co-author e-mail ruparel@uthscsa.edu
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