title: Five-year changes in periodontal parameters after apical surgery.
abstract: BACKGROUND
  Most clinical studies on the outcome of apical surgery concentrate on periapical healing based on radiographic and clinical characteristics (signs and symptoms). This study focuses on long-term changes in periodontal parameters after apical surgery.
  
  
  METHODS
  Periodontal parameters (ie, probing depth [PD], level of gingival margin [GM], and calculated clinical attachment level [CAL]) were collected at baseline and at 1 and 5 years after apical surgery. Changes in PD, GM, and CAL were calculated over time and were also evaluated in relation to patient-, tooth-, and treatment-related covariables.
  
  
  RESULTS
  One hundred eighty-six of 242 initially identified teeth could be evaluated. Significant changes in GM and CAL were observed at facial sites during the first year after surgery (mean recession of GM was 0.29 mm, mean CAL loss was 0.20 mm), but none of the periodontal parameters significantly changed between 1 and 5 years after apical surgery. With regard to covariables, the type of incision technique was found to be the major factor affecting changes in GM and CAL between baseline and 1 year after surgery. Age, smoking, and type of periapical healing were the variables influencing the periodontal parameters over the longer observation period of up to 5 years.
  
  
  CONCLUSIONS
  Patients should be informed about possible changes in periodontal parameters (gingival recession and loss of attachment) after apical surgery. The surgery itself appears to account for changes observed during the first year, whereas patient- and healing-related factors seem to affect periodontal changes seen thereafter.
authors.affiliation: Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, Bern, Switzerland. thomas.vonarx@zmk.unibe.ch
authors.forename: Thomas
authors.initials: T
authors.lastname: von Arx
authors.forename: Mohammed
authors.initials: M
authors.lastname: Alsaeed
authors.forename: Giovanni E
authors.initials: GE
authors.lastname: Salvi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D005260:Female; D005881:Gingiva / Q000601:surgery; D005889:Gingival Recession / Q000175:diagnosis* / Q000209:etiology; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D017622:Periodontal Attachment Loss / Q000175:diagnosis* / Q000209:etiology; D010512:Periodontal Index; D010514:Periodontal Pocket / Q000175:diagnosis* / Q000209:etiology; D011859:Radiography; D012390:Root Canal Therapy / Q000009:adverse effects* / Q000379:methods; D012737:Sex Factors; D019227:Tooth Apex / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult