title: Periapical microsurgery: the effect of root dentinal defects on short- and long-term outcome.
abstract: BACKGROUND
  The purpose of this prospective clinical study was to evaluate the clinical outcome of endodontic microsurgery on roots exhibiting the presence or absence of dentinal defects at 1-year and 3-year follow-up period.
  
  
  METHODS
  One hundred fifty-five teeth were treated with periapical microsurgery using a modern microsurgical protocol in a private practice setting. The root apices were resected and inspected for dentinal defects with a surgical operating microscope and a 0.8-mm head diameter light-emitting diode microscope diagnostic probe light. After inspection, root-end preparations were performed using ultrasonic tips, and root-end fillings were placed. Follow-up visits occurred at 1 year and 3 years postoperatively. The primary outcome measure used was the change in the radiographic apical bone density, and the secondary outcome measure used was the absence of clinical symptoms.
  
  
  RESULTS
  Of the 155 treated teeth, a total of 134 teeth were assessed at the 1-year follow-up and 127 teeth at the 3-year evaluation. In the "intact" group, 94.8% healed at 1 year, and 97.3% healed at 3 years. In the "dentinal defect" group, 29.8% healed at 1 year, and 31.5% healed at 3 years. The baseline root condition of either "dentinal defect" or "intact" showed a statistical difference in the healing outcome at both 1 and 3 years.
  
  
  CONCLUSIONS
  This prospective periapical microsurgery study showed a significant superior clinical outcome for intact roots when compared with roots with dentinal defects at both 1 year and at 3 years postoperatively.
authors.affiliation: Department of Endodontics, UNC School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina. Electronic address: pztawil@gmail.com.
authors.forename: Peter Z
authors.initials: PZ
authors.lastname: Tawil
authors.affiliation: Department of Endodontics, UNC School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
authors.forename: Veeral M
authors.initials: VM
authors.lastname: Saraiya
authors.affiliation: Department of Endodontics, University of the Pacific, Stockton, California.
authors.forename: Johnah C
authors.initials: JC
authors.lastname: Galicia
authors.affiliation: Department of Endodontics, UNC School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
authors.forename: Derek J
authors.initials: DJ
authors.lastname: Duggan
mesh_terms: D000328:Adult; D001047:Apicoectomy / Q000009:adverse effects / Q000379:methods*; D003804:Dentin / Q000503:physiopathology*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008866:Microsurgery / Q000009:adverse effects* / Q000379:methods; D063868:Patient Outcome Assessment; D010485:Periapical Periodontitis / Q000503:physiopathology / Q000601:surgery*; D011446:Prospective Studies; D012184:Retrograde Obturation / Q000009:adverse effects / Q000379:methods; D012387:Root Canal Filling Materials / Q000627:therapeutic use; D012389:Root Canal Obturation / Q000009:adverse effects / Q000379:methods; D014092:Tooth Root / Q000503:physiopathology / Q000601:surgery
chemical_list: D012387:Root Canal Filling Materials
keywords: Apicoectomy; craze line; dentinal defect; endodontic microsurgery; outcome