Contemporary therapeutic approach of periapical lesions: the role of surgical intervention – Literature Review
Nikolaos PAPATHANASIS, Nadia THEOLOGIE-LYGIDAKIS
Department of Oral and Maxillofacial Surgery, School of Dentistry, National and Kapodistrian University of Athens, Greece (Head: Professor C. Perisanidis)
Hellenic Archives of Oral & Maxillofacial Surgery (2019) 1, 13-23
SUMMARY: The therapeutic approach of periapical lesions of odontogenic origin is a subject of continuous discussion. Their initial treatment is usually achieved with the conventional endodontic treatment of the involved tooth or the revision of a preexisting failed endodontic therapy, with or without additional surgical excision of the periapical lesion. Modern endodontic approach, given the significant progress regarding devices, tools and filling materials, is bibliographically reported to achieve a remission of the periapical lesion, more often than before, as the tooth derived microbial load which maintains it, is minimized or zeroed. Nevertheless and in spite of the above, recent epidemiological studies have shown a high rate of endodontically treated teeth with chronic periapical lesions, which have not subsided.
The aim of this article is to review the recent literature on the contemporary treatment of periapical lesions and on the necessity or not of periapical surgery.
KEY WORDS: Periapical lesions, endodontic treatment, periapical surgery, apicoectomy.
REFERENCES
Andreasen J, Rud J: Modes of healing histologically after endodontic surgery in 70 cases, In: Int J Oral Surg. 1972, pp. 148-160
Baek S, Plenk H, Kim S: Periapical tissue responses and cementum re- generation with amalgam, SuperEBA, and MTA as root-end filling materials, In: J. Endodont. 2005, pp. 444–449
Bergenholtz G, Lekholm U, Milthon R, Heden G, Odesjo B, Engstrom B: Retreatment of endodontic fillings, In: Scand J Dent Res. 1979, pp. 217-224
Bernabé P, Gomes-Filho J, Rocha W, Nery M, Otoboni-Filho J, Dezan- Junior E : Histological evaluation of MTA as a root-end filling ma- terial, In : Int. Endod. J. 2007, pp. 758–765
Boyne P, Lyon H, Miller C: The effects of osseous implant materials on regeneration of alveolar cortex, In: Oral Surg Oral Med Oral Pathol. 1961, pp. 369-378
Brondum N, Jensen VJ: Recurrence of keratocysts and decompression treatment. A long-term follow-up of forty-four cases, In: Oral Surg Oral Med Oral Pathol. 1991, pp. 265-269
Çaliskan MK: Prognosis of large cyst-like periapical lesions following nonsurgical root canal treatment: a clinical review, In: Int. Endod. J. 2004, pp. 408-416
Camilleri J, Pitt Ford T: Mineral trioxide aggregate: a review of the con- stituents and biological properties of the material, In: Int. Endod. J. 2006, pp. 747–754
Chong B, Ford T, Hudson M: A prospective clinical study of mineral trioxide aggregate and IRM when used as root-end filling materials in endodontic surgery, In: Int. Endod. J. 2003, pp. 520–526
Christiansen R, Kirkevang L, Horsted-Bindslev P, Wenzel A: Random- ized clinical trial of root-end resection followed by root-end filling with mineral trioxide aggregate or smoothing of the orthograde gutta–percha root filling – 1-year follow up, In: Int. Endod. J. 2009, pp.105–114
Del Fabbro M, Corbella S, Sequeira-Byron P, Tsesis I, Rosen E, Lolato A, Taschieri S: Endodontic procedures for retreatment of periapi- cal lesions, In: Cochrane Database Syst Rev. 2016, pp. 5-11
Dorn SO, Gartner AH: Retrograde filling materials: a retrospective suc- cess-failure study of amalgam, EBA, and IRM, In: J Endod. 1990, pp. 391-393
European Society of Endodontology Quality guidelines for endodontic treatment: consensus report of the European Society of Endodon- tology, In: Int Endod J. 2006, pp. 921-930
Ferrailo DM, Veitz-Keenan A: No clinical quantifiable benefits between non-surgical and surgical endodontic treatment, In: Evid Based Dent. 2017, pp. 75-76
Gilheany PA, Figdor D, Tyas MJ: Apical dentin permeability and mi- croleakage associated with root end resection and retrograde fill- ing, In: J Endod.1994, pp. 22-26
Gorni F, Gagliani M: The outcome of endodontic retreatment: a 2-yr follow-up, In: J Endod. 2004, pp. 1-4
Halse A, Molven O, Grung B: Follow-up after periapical surgery: the value of the 1-year control, In: Endod. Dent. Traumatol. 1991, pp. 246–250
Hjorting-Hansen E, Andreasen J: Incomplete bone healing of experi- mental cavities in dog mandibles, In: Br J Oral Surg. 1971, pp. 33- 40
Holland R, Gomes JE, Cintra L, Queiroz I, Estrela C: Factors affecting the periapical healing process of endodontically treated teeth, In: J Appl Oral Sci. 2017, pp. 465-476
Jesslen P, Zetterqvist L, Heimdahl A: Long-term results of amalgam versus glass ionomer cement as apical sealant after apicoectomy, In: Oral Surg. Oral Med. Oral Pathol. Oral Radiol. Endod. 1995, pp.101–103
Jokinen MA, Kotilainen R, Poikkeus P: Clinical and radiographic study of pulpectomy and root canal therapy, In: Scand J Dent Res 1978, pp. 366-373
Kang M, Jung H, Song M, Kim SY, Kim HC, Kim E: Outcome of non- surgical retreatment and endodontic microsurgery: a meta-analy- sis, In: Clin Oral Investig. 2015, pp. 569-582
Karunakaran JV, Abraham CS, Karthik AK, Jayaprakash N: Successful Nonsurgical Management of Periapical Lesions of Endodontic Ori- gin: A Conservative Orthograde Approach, In: J Pharm Bioallied Sci. 2017, pp.246-251
Kerekes K, Tronstad L: Long-term results of endodontic treatment per- formed with a standardized technique, In: J Endod. 1979, pp. 83- 90
Kim E, Song JS, Jung IY, Lee SJ, Kim S: Prospective clinical study evalu- ating endodontic microsurgery outcomes for cases with lesions of endodontic origin compared with cases with lesions of com- bined periodontal-endodontic origin, In: J Endod. 2008, pp. 546– 551
Kim S, Kratchman S: Modern endodontic surgery concepts and prac- tice: a review, In: J Endod. 2006, pp. 601-623
Kim S, Pecora G, Rubinstein R: Comparison of traditional and micro- surgery in endodontics, In: Color atlas of microsurgery in en- dodontics, W.B. Saunders, Philadelphia 2001, pp. 5-11
Kovác J, Kovác D: Histopathology and etiopathogenesis of chronic apical periodontitis--periapical granuloma, In: Epidemiol Mikrobiol Imunol. 2011, pp. 77-86
Lalonde ER, Luebke RG: The frequency and distribution of periapical cysts and granulomas: an evaluation of 800 specimens, In: Oral Surg Oral Med Oral Pathol. 1968, pp. 861-868
Lin LM, Chen MY, Ricucci D, Rosenberg PA: Guided tissue regenera- tion in periapical surgery, In: J Endod. 2010, pp. 618-625
Lin LM, Huang GT, Rosenberg PA: Proliferation of epithelial cell rests, formation of apical cysts, and regression of apical cysts after peri- apical wound healing, In: J Endod. 2007, pp. 908-916
Lin LM, Ricucci D, Lin J, Rosenberg PA: Nonsurgical root canal therapy of large cyst-like inflammatory periapical lesions and inflammatory apical cysts, In: J Endod. 2009, pp. 607-615
Lindeboom JA, Frenken JW, Kroon FH, van den Akker HP: A compar- ative prospective randomized clinical study of MTA and IRM as root-end filling materials in single-rooted teeth in endodontic sur- gery, In: Oral Surg. Oral Med. Oral Pathol. Oral Radiol. Endod. 2005, pp. 495–500
Molven O, Halse A, Grung B: Observer strategy and the radiographic classification of healing after endodontic surgery, In: Int. J. Oral Maxillofac. Surg. 1987, pp. 432–439
Molven O, Halse A, Grung B: Incomplete healing (scar tissue) after periapical surgery–rRadiographic findings 8 to 12 years after treat- ment, In: J Endod. 1996, pp. 264–268
Nair PN, Sundqvist G, Sjögren U: Experimental evidence supports the abscess theory of development of radicular cysts, In: Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008; pp. 294-303
Nair PN: New perspectives on radicular cysts: do they heal? In: Int Endod J. 1998, pp. 155-160
Nair PN: Non-microbial etiology: foreign body reaction maintaining post-treatment apical periodontitis, In: Endod Topics 2003, pp. 114-134
Nair PN: Pathogenesis of apical periodontitis and the causes of en- dodontic failures, In: Crit Rev Oral Biol Med 2004, pp. 348-381
Nair PN, Pajarola G, Schroeder HE: Types and incidence of human periapical lesions obtained with extracted teeth, In: Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1996, pp.93-102
Nair PN, Sjogren U, Schumacher E, Sundqvist G: Radicular cyst affect- ing a root-filled human tooth: a long-term post-treatment follow- up, In: Int Endod J. 1993, pp. 225-233
Öğütlü F, Karaca İ: Clinical and Radiographic Outcomes of Apical Sur- gery: A Clinical Study, In: J Maxillofac Oral Surg. 2018, pp.75-83
Peterson J, Gutmann JL: The outcome of endodontic resurgery: a sys- tematic review, In: Int Endod J. 2001, pp.169-175
Poggio C, Lombardini M, Conti A, Rindi S: Solubility of root-end filling materials: a comparative study, In: J. Endodont. 2007, pp. 1094– 1097
Raedel M, Hartmann A, Bohm S, Walter MH: Three year outcomes of apicectomy (apicoectomy): Mining an insur- ance database. J Dent. 2015, pp. 1218-1222
Rahbaran S, Gilthorpe MS, Harrison SD, Gulabivala K: Comparison of clinical outcome of periapical surgery in endodontic and oral sur- gery units of a teaching dental hospital: a retrospective study, In: Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2001, pp. 700-709
Richman MJ: The use of ultrasonics in root canal therapy and resection, In: J Dent Med. 1957, pp. 12-18
Rubinstein RA, Kim S: Short-term observation of the results of en- dodontic surgery with the use of a surgical operation microscope and Super-EBA as root-end filling material, In: J Endod. 1999, pp. 43-48
Rubinstein RA, Kim S: Long-term follow-up of cases considered healed one year after apical microsurgery, In: J Endod. 2002, pp. 378-383
Rud J, Andreasen JO, Möller Jensen JE: Radiographic criteria for the as- sessment of healing after endodontic surgery, In: Int. J. Oral Surg. 1972, pp. 195–214
Saunders WP: A prospective clinical study of periradicular surgery using mineral trioxide aggregate as a root-end filling, In: J.En- dodont. 2008, pp.660–665
Segura-Egea JJ, Jiménez-Pinzón A, Poyato-Ferrera M, Velasco-Ortega E, Ríos-Santos JV: Periapical status and quality of root fillings and coronal restorations in an adult Spanish population, In: Int Endod J. 2004, pp. 525-530
Sigurdsson A, Le KT, Woo SM, Rassoulian SH, McLachlan K, Abbassi F, Garland RW: Six-month healing success rates after endodontic treatment using the novel GentleWave™ System: The pure prospective multi-center clinical study, In: J Clin Exp Dent. 2016, pp.290–298
Simon J: Incidence of periapical cysts in relation to the root canal, In: J Endod.1980, pp. 845-848
Taschieri S, del Fabbro M, Testori T: Microscope versus endoscope in root-end management: a randomized controlled study, In: Int. J. Oral Maxillofac. Surg. 2008, pp. 1022–1026
Testori T, Capelli M, Milani S, Weinstein SR: Success and failure in peri- radicular surgery: a longitudinal retrospective analysis, In: Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1999, pp. 493-498
Torres-Lagares D, Segura-Egea JJ, Rodríguez-Caballero A, Llamas-Car- reras JM, Gutiérrez-Pérez JL: Treatment of a large maxillary cyst with marsupialization, decompression, surgical endodon- tic therapy and enucleation, In: J Can Dent Assoc. 2011, pp. 77- 87
Tortorici S, Difalco P, Caradonna L, Tetè S: Traditional endodontic surgery versus modern technique: a 5-year controlled clinical trial, In: J Craniofac Surg. 2014, pp. 804-807
Tsesis I, Rosen E, Schwartz-Arad D, Fuss Z: Retrospective evaluation of surgical endodontic treatment: traditional versus modern tech- niques, In: J. Endodont. 2006, pp. 412–416
Tsesis I, Rosen E, Taschieri S, Telishevsky Strauss Y, Ceresoli V, Del Fabbro M: Outcomes of surgical endodontic treatment per- formed by a modern technique: an updated meta-analysis of the literature, In: J Endod. 2013, pp. 332-339
von Arx T: Failed root canals: the case for apicoectomy (periradicular surgery), In: J. Oral Maxillofac. Surg. 2005, pp. 832–837
von Arx T: Apical surgery: A review of current techniques and out- come, In: Saudi Dent J. 2011, pp. 9-15
von Arx T, Britain S, Cochran DL, Schenk RK, Nummikoski PV, Buser D: Healing of periapical lesions with complete loss of the buccal bone plate: a histologic study in the canine mandible, In: Int. J. Pe- riodont. Restor. Dent. 2003, pp. 157–167
von Arx T, Hänni S, Jensen SS: Clinical and radiographic assessment of various predictors for healing outcome 1 year after periapical surgery, In: J. Endodont. 2007, pp.123–128
von Arx T, Roux E, Bürgin W: Treatment decisions in 330 cases re- ferred for apical surgery, In: J Endod. 2014, pp.187-191
von Arx T, Salvi G: Incision techniques and flap designs for apical sur- gery in the anterior maxilla, In: Eur. J. Esthet. Dent. 2008, pp.110– 126
Waplington M, Lumley PJ, Walmsley AD, Blunt L: Cutting ability of an ultrasonic retrograde cavity preparation instrument Endod, In: Dent Traumatol. 1995, pp. 177-118
Wu MK, Dummer PM, Wesselink PR: Consequences of and strategies to deal with residual post-treatment root canal infection, In: Int Endod J. 2006, pp. 343-356
Yazdi PM, Schou S, Jensen SS, Stoltze K, Kenrad B, Sewerin I : Den- tine-bonded resin composite (Retroplast) for root-end filling: a prospective clinical and radiographic study with a mean follow-up period of 8 years, In: Int. Endod. J. 2007, pp. 493–503
Zesis A, Lin S, Fuss Z: Endodontic surgery (apicoectomy)-success rate of more than 90% using dental operating microscope and ultra- sonic tips, In: Refuat Hapeh Vehashinayim 2005, pp. 33-41
Zuolo ML, Ferreira MO, Gutmann JL: Prognosis in periradicular surgery: a clinical prospective study, In: Int. Endod. J. 2000, pp. 91–98
Department of Oral and Maxillofacial Surgery, School of Dentistry, National and Kapodistrian University of Athens, Greece (Head: Professor C. Perisanidis)
Hellenic Archives of Oral & Maxillofacial Surgery (2019) 1, 13-23
SUMMARY: The therapeutic approach of periapical lesions of odontogenic origin is a subject of continuous discussion. Their initial treatment is usually achieved with the conventional endodontic treatment of the involved tooth or the revision of a preexisting failed endodontic therapy, with or without additional surgical excision of the periapical lesion. Modern endodontic approach, given the significant progress regarding devices, tools and filling materials, is bibliographically reported to achieve a remission of the periapical lesion, more often than before, as the tooth derived microbial load which maintains it, is minimized or zeroed. Nevertheless and in spite of the above, recent epidemiological studies have shown a high rate of endodontically treated teeth with chronic periapical lesions, which have not subsided.
The aim of this article is to review the recent literature on the contemporary treatment of periapical lesions and on the necessity or not of periapical surgery.
KEY WORDS: Periapical lesions, endodontic treatment, periapical surgery, apicoectomy.
REFERENCES
Andreasen J, Rud J: Modes of healing histologically after endodontic surgery in 70 cases, In: Int J Oral Surg. 1972, pp. 148-160
Baek S, Plenk H, Kim S: Periapical tissue responses and cementum re- generation with amalgam, SuperEBA, and MTA as root-end filling materials, In: J. Endodont. 2005, pp. 444–449
Bergenholtz G, Lekholm U, Milthon R, Heden G, Odesjo B, Engstrom B: Retreatment of endodontic fillings, In: Scand J Dent Res. 1979, pp. 217-224
Bernabé P, Gomes-Filho J, Rocha W, Nery M, Otoboni-Filho J, Dezan- Junior E : Histological evaluation of MTA as a root-end filling ma- terial, In : Int. Endod. J. 2007, pp. 758–765
Boyne P, Lyon H, Miller C: The effects of osseous implant materials on regeneration of alveolar cortex, In: Oral Surg Oral Med Oral Pathol. 1961, pp. 369-378
Brondum N, Jensen VJ: Recurrence of keratocysts and decompression treatment. A long-term follow-up of forty-four cases, In: Oral Surg Oral Med Oral Pathol. 1991, pp. 265-269
Çaliskan MK: Prognosis of large cyst-like periapical lesions following nonsurgical root canal treatment: a clinical review, In: Int. Endod. J. 2004, pp. 408-416
Camilleri J, Pitt Ford T: Mineral trioxide aggregate: a review of the con- stituents and biological properties of the material, In: Int. Endod. J. 2006, pp. 747–754
Chong B, Ford T, Hudson M: A prospective clinical study of mineral trioxide aggregate and IRM when used as root-end filling materials in endodontic surgery, In: Int. Endod. J. 2003, pp. 520–526
Christiansen R, Kirkevang L, Horsted-Bindslev P, Wenzel A: Random- ized clinical trial of root-end resection followed by root-end filling with mineral trioxide aggregate or smoothing of the orthograde gutta–percha root filling – 1-year follow up, In: Int. Endod. J. 2009, pp.105–114
Del Fabbro M, Corbella S, Sequeira-Byron P, Tsesis I, Rosen E, Lolato A, Taschieri S: Endodontic procedures for retreatment of periapi- cal lesions, In: Cochrane Database Syst Rev. 2016, pp. 5-11
Dorn SO, Gartner AH: Retrograde filling materials: a retrospective suc- cess-failure study of amalgam, EBA, and IRM, In: J Endod. 1990, pp. 391-393
European Society of Endodontology Quality guidelines for endodontic treatment: consensus report of the European Society of Endodon- tology, In: Int Endod J. 2006, pp. 921-930
Ferrailo DM, Veitz-Keenan A: No clinical quantifiable benefits between non-surgical and surgical endodontic treatment, In: Evid Based Dent. 2017, pp. 75-76
Gilheany PA, Figdor D, Tyas MJ: Apical dentin permeability and mi- croleakage associated with root end resection and retrograde fill- ing, In: J Endod.1994, pp. 22-26
Gorni F, Gagliani M: The outcome of endodontic retreatment: a 2-yr follow-up, In: J Endod. 2004, pp. 1-4
Halse A, Molven O, Grung B: Follow-up after periapical surgery: the value of the 1-year control, In: Endod. Dent. Traumatol. 1991, pp. 246–250
Hjorting-Hansen E, Andreasen J: Incomplete bone healing of experi- mental cavities in dog mandibles, In: Br J Oral Surg. 1971, pp. 33- 40
Holland R, Gomes JE, Cintra L, Queiroz I, Estrela C: Factors affecting the periapical healing process of endodontically treated teeth, In: J Appl Oral Sci. 2017, pp. 465-476
Jesslen P, Zetterqvist L, Heimdahl A: Long-term results of amalgam versus glass ionomer cement as apical sealant after apicoectomy, In: Oral Surg. Oral Med. Oral Pathol. Oral Radiol. Endod. 1995, pp.101–103
Jokinen MA, Kotilainen R, Poikkeus P: Clinical and radiographic study of pulpectomy and root canal therapy, In: Scand J Dent Res 1978, pp. 366-373
Kang M, Jung H, Song M, Kim SY, Kim HC, Kim E: Outcome of non- surgical retreatment and endodontic microsurgery: a meta-analy- sis, In: Clin Oral Investig. 2015, pp. 569-582
Karunakaran JV, Abraham CS, Karthik AK, Jayaprakash N: Successful Nonsurgical Management of Periapical Lesions of Endodontic Ori- gin: A Conservative Orthograde Approach, In: J Pharm Bioallied Sci. 2017, pp.246-251
Kerekes K, Tronstad L: Long-term results of endodontic treatment per- formed with a standardized technique, In: J Endod. 1979, pp. 83- 90
Kim E, Song JS, Jung IY, Lee SJ, Kim S: Prospective clinical study evalu- ating endodontic microsurgery outcomes for cases with lesions of endodontic origin compared with cases with lesions of com- bined periodontal-endodontic origin, In: J Endod. 2008, pp. 546– 551
Kim S, Kratchman S: Modern endodontic surgery concepts and prac- tice: a review, In: J Endod. 2006, pp. 601-623
Kim S, Pecora G, Rubinstein R: Comparison of traditional and micro- surgery in endodontics, In: Color atlas of microsurgery in en- dodontics, W.B. Saunders, Philadelphia 2001, pp. 5-11
Kovác J, Kovác D: Histopathology and etiopathogenesis of chronic apical periodontitis--periapical granuloma, In: Epidemiol Mikrobiol Imunol. 2011, pp. 77-86
Lalonde ER, Luebke RG: The frequency and distribution of periapical cysts and granulomas: an evaluation of 800 specimens, In: Oral Surg Oral Med Oral Pathol. 1968, pp. 861-868
Lin LM, Chen MY, Ricucci D, Rosenberg PA: Guided tissue regenera- tion in periapical surgery, In: J Endod. 2010, pp. 618-625
Lin LM, Huang GT, Rosenberg PA: Proliferation of epithelial cell rests, formation of apical cysts, and regression of apical cysts after peri- apical wound healing, In: J Endod. 2007, pp. 908-916
Lin LM, Ricucci D, Lin J, Rosenberg PA: Nonsurgical root canal therapy of large cyst-like inflammatory periapical lesions and inflammatory apical cysts, In: J Endod. 2009, pp. 607-615
Lindeboom JA, Frenken JW, Kroon FH, van den Akker HP: A compar- ative prospective randomized clinical study of MTA and IRM as root-end filling materials in single-rooted teeth in endodontic sur- gery, In: Oral Surg. Oral Med. Oral Pathol. Oral Radiol. Endod. 2005, pp. 495–500
Molven O, Halse A, Grung B: Observer strategy and the radiographic classification of healing after endodontic surgery, In: Int. J. Oral Maxillofac. Surg. 1987, pp. 432–439
Molven O, Halse A, Grung B: Incomplete healing (scar tissue) after periapical surgery–rRadiographic findings 8 to 12 years after treat- ment, In: J Endod. 1996, pp. 264–268
Nair PN, Sundqvist G, Sjögren U: Experimental evidence supports the abscess theory of development of radicular cysts, In: Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008; pp. 294-303
Nair PN: New perspectives on radicular cysts: do they heal? In: Int Endod J. 1998, pp. 155-160
Nair PN: Non-microbial etiology: foreign body reaction maintaining post-treatment apical periodontitis, In: Endod Topics 2003, pp. 114-134
Nair PN: Pathogenesis of apical periodontitis and the causes of en- dodontic failures, In: Crit Rev Oral Biol Med 2004, pp. 348-381
Nair PN, Pajarola G, Schroeder HE: Types and incidence of human periapical lesions obtained with extracted teeth, In: Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1996, pp.93-102
Nair PN, Sjogren U, Schumacher E, Sundqvist G: Radicular cyst affect- ing a root-filled human tooth: a long-term post-treatment follow- up, In: Int Endod J. 1993, pp. 225-233
Öğütlü F, Karaca İ: Clinical and Radiographic Outcomes of Apical Sur- gery: A Clinical Study, In: J Maxillofac Oral Surg. 2018, pp.75-83
Peterson J, Gutmann JL: The outcome of endodontic resurgery: a sys- tematic review, In: Int Endod J. 2001, pp.169-175
Poggio C, Lombardini M, Conti A, Rindi S: Solubility of root-end filling materials: a comparative study, In: J. Endodont. 2007, pp. 1094– 1097
Raedel M, Hartmann A, Bohm S, Walter MH: Three year outcomes of apicectomy (apicoectomy): Mining an insur- ance database. J Dent. 2015, pp. 1218-1222
Rahbaran S, Gilthorpe MS, Harrison SD, Gulabivala K: Comparison of clinical outcome of periapical surgery in endodontic and oral sur- gery units of a teaching dental hospital: a retrospective study, In: Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2001, pp. 700-709
Richman MJ: The use of ultrasonics in root canal therapy and resection, In: J Dent Med. 1957, pp. 12-18
Rubinstein RA, Kim S: Short-term observation of the results of en- dodontic surgery with the use of a surgical operation microscope and Super-EBA as root-end filling material, In: J Endod. 1999, pp. 43-48
Rubinstein RA, Kim S: Long-term follow-up of cases considered healed one year after apical microsurgery, In: J Endod. 2002, pp. 378-383
Rud J, Andreasen JO, Möller Jensen JE: Radiographic criteria for the as- sessment of healing after endodontic surgery, In: Int. J. Oral Surg. 1972, pp. 195–214
Saunders WP: A prospective clinical study of periradicular surgery using mineral trioxide aggregate as a root-end filling, In: J.En- dodont. 2008, pp.660–665
Segura-Egea JJ, Jiménez-Pinzón A, Poyato-Ferrera M, Velasco-Ortega E, Ríos-Santos JV: Periapical status and quality of root fillings and coronal restorations in an adult Spanish population, In: Int Endod J. 2004, pp. 525-530
Sigurdsson A, Le KT, Woo SM, Rassoulian SH, McLachlan K, Abbassi F, Garland RW: Six-month healing success rates after endodontic treatment using the novel GentleWave™ System: The pure prospective multi-center clinical study, In: J Clin Exp Dent. 2016, pp.290–298
Simon J: Incidence of periapical cysts in relation to the root canal, In: J Endod.1980, pp. 845-848
Taschieri S, del Fabbro M, Testori T: Microscope versus endoscope in root-end management: a randomized controlled study, In: Int. J. Oral Maxillofac. Surg. 2008, pp. 1022–1026
Testori T, Capelli M, Milani S, Weinstein SR: Success and failure in peri- radicular surgery: a longitudinal retrospective analysis, In: Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1999, pp. 493-498
Torres-Lagares D, Segura-Egea JJ, Rodríguez-Caballero A, Llamas-Car- reras JM, Gutiérrez-Pérez JL: Treatment of a large maxillary cyst with marsupialization, decompression, surgical endodon- tic therapy and enucleation, In: J Can Dent Assoc. 2011, pp. 77- 87
Tortorici S, Difalco P, Caradonna L, Tetè S: Traditional endodontic surgery versus modern technique: a 5-year controlled clinical trial, In: J Craniofac Surg. 2014, pp. 804-807
Tsesis I, Rosen E, Schwartz-Arad D, Fuss Z: Retrospective evaluation of surgical endodontic treatment: traditional versus modern tech- niques, In: J. Endodont. 2006, pp. 412–416
Tsesis I, Rosen E, Taschieri S, Telishevsky Strauss Y, Ceresoli V, Del Fabbro M: Outcomes of surgical endodontic treatment per- formed by a modern technique: an updated meta-analysis of the literature, In: J Endod. 2013, pp. 332-339
von Arx T: Failed root canals: the case for apicoectomy (periradicular surgery), In: J. Oral Maxillofac. Surg. 2005, pp. 832–837
von Arx T: Apical surgery: A review of current techniques and out- come, In: Saudi Dent J. 2011, pp. 9-15
von Arx T, Britain S, Cochran DL, Schenk RK, Nummikoski PV, Buser D: Healing of periapical lesions with complete loss of the buccal bone plate: a histologic study in the canine mandible, In: Int. J. Pe- riodont. Restor. Dent. 2003, pp. 157–167
von Arx T, Hänni S, Jensen SS: Clinical and radiographic assessment of various predictors for healing outcome 1 year after periapical surgery, In: J. Endodont. 2007, pp.123–128
von Arx T, Roux E, Bürgin W: Treatment decisions in 330 cases re- ferred for apical surgery, In: J Endod. 2014, pp.187-191
von Arx T, Salvi G: Incision techniques and flap designs for apical sur- gery in the anterior maxilla, In: Eur. J. Esthet. Dent. 2008, pp.110– 126
Waplington M, Lumley PJ, Walmsley AD, Blunt L: Cutting ability of an ultrasonic retrograde cavity preparation instrument Endod, In: Dent Traumatol. 1995, pp. 177-118
Wu MK, Dummer PM, Wesselink PR: Consequences of and strategies to deal with residual post-treatment root canal infection, In: Int Endod J. 2006, pp. 343-356
Yazdi PM, Schou S, Jensen SS, Stoltze K, Kenrad B, Sewerin I : Den- tine-bonded resin composite (Retroplast) for root-end filling: a prospective clinical and radiographic study with a mean follow-up period of 8 years, In: Int. Endod. J. 2007, pp. 493–503
Zesis A, Lin S, Fuss Z: Endodontic surgery (apicoectomy)-success rate of more than 90% using dental operating microscope and ultra- sonic tips, In: Refuat Hapeh Vehashinayim 2005, pp. 33-41
Zuolo ML, Ferreira MO, Gutmann JL: Prognosis in periradicular surgery: a clinical prospective study, In: Int. Endod. J. 2000, pp. 91–98
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