Outcomes of periradicular surgery in cases with apical pathosis and untreated canals.
OBJECTIVE
Surgical management is intended to eliminate or block infection originating in the root canals. The root end is customarily sealed to prevent pathogenic products remaining in the root canal from reaching the periradicular tissues. The purpose of this study was to evaluate the microbiologic and radiographic outcomes of surgical treatment of periradicular pathosis associated with teeth with necrotic pulps.


METHODS
One tooth from each of 10 patients was root-end resected and root-end filled without prior root canal treatment. One year postoperatively, the outcomes were assessed radiographically and the root canals were sampled for bacteria.


RESULTS
Radiographic examination showed complete or incomplete (scar tissue) healing in 5 teeth and uncertain healing in the other 5 teeth. Bacteriologic samples from the root canals were positive in 9 of the 10 cases.


CONCLUSIONS
In teeth with necrotic pulps, treatment of periradicular pathosis by surgery and root-end filling may show radiographic evidence of satisfactory healing 1 year postoperatively. However, viable bacteria may persist in the canals, constituting a potential risk factor for recurrence of periradicular pathosis.
Department of Cariology and Endodontics, Karolinska Institutet, Huddinge University Hospital, Sweden.
J
J
Danin
L E
LE
Linder
G
G
Lundqvist
L
L
Ohlsson
L O
LO
Ramsköld
T
T
Strömberg
D000328:Adult; D000368:Aged; D001047:Apicoectomy; D001421:Bacteria, Anaerobic / Q000302:isolation & purification; D003786:Dental Pulp Cavity / Q000382:microbiology*; D003790:Dental Pulp Necrosis / Q000150:complications* / Q000382:microbiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010484:Periapical Granuloma / Q000150:complications* / Q000601:surgery*; D011842:Radicular Cyst / Q000150:complications / Q000601:surgery; D012184:Retrograde Obturation; D016896:Treatment Outcome