Outcomes of Nonsurgical Retreatment and Endodontic Surgery: A Systematic Review

Department of Endodontics, School of Dentistry, Loma Linda University, Loma Linda, CA 92350, USA. .
Journal of endodontics (Impact Factor: 3.38). 08/2009; 35(7):930-7. DOI: 10.1016/j.joen.2009.04.023
Source: PubMed


The purpose of this systematic review was to compare the clinical and radiographic outcomes of nonsurgical retreatment with those of endodontic surgery to determine which modality offers more favorable outcomes.
The study began with targeted electronic searches of MEDLINE, PubMed, and Cochrane databases, followed with exhaustive hand searching and citation mining for all articles reporting clinical and/or radiographic outcomes for at least a mean follow-up of 2 years for these procedures. Pooled and weighted success rates were determined from a meta-analysis of the data abstracted from the articles.
A significantly higher success rate was found for endodontic surgery at 2-4 years (77.8%) compared with nonsurgical retreatment for the same follow-up period (70.9%; P < .05). At 4-6 years, however, this relationship was reversed, with nonsurgical retreatment showing a higher success rate of 83.0% compared with 71.8% for endodontic surgery (P < .05). Insufficient numbers of articles were available to make comparisons after 6 years of follow-up period. Endodontic surgery studies showed a statistically significant decrease in success with each increasing follow-up interval (P < .05). The weighted success for 2-4 years was 77.8%, which declined at 4-6 years to 71.8% and further declined at 6+ years to 62.9% (P < .05). Conversely, the nonsurgical retreatment success rates demonstrated a statistically significant increase in weighted success from 2-4 years (70.9%) to 4-6 years (83.0%; P < .05).
On the basis of these results it appears that endodontic surgery offers more favorable initial success, but nonsurgical retreatment offers a more favorable long-term outcome.

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Available from: Robert Handysides, Sep 02, 2014
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    • "For longer observation times, there were no differences between the treatments [1]. In a systematic review published two years later, success rates for apicectomy of 77.8% for 2–4 years and 71.8% at 4–6 years were found [2]. In comparison, there was again no consistent tendency toward the superiority of surgical or non-surgical retreatment. "
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    Journal of dentistry 07/2015; 43(10). DOI:10.1016/j.jdent.2015.07.016 · 2.75 Impact Factor
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    • "Although endodontic surgery offers more favourable initial success, nonsurgical retreatment yields a more favourable long-term outcome in these failed cases [1]. A retreatment procedure in endodontic practice requires complete removal of the original root filling materials and enlarging and repreparing the root canal prior to refilling [1] [2]. Many techniques have been suggested for this purpose, including the use of rotary NiTi instruments [3] [4] and root canal filling-dissolving solvents [2] [5]. "
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    The Scientific World Journal 11/2013; 2013:475178. DOI:10.1155/2013/475178 · 1.73 Impact Factor
    • "Despite the superior characteristics of MTA, its retrievability from the root canal has been regarded as one of its main disadvantages. Although initial root canal therapy has been shown to be a predictable procedure with a high degree of success, failures can occur after treatment.[4] Rotary and ultrasonic instruments alone have not been shown to be efficient in the removal of MTA from root canal.[5] "
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