title: Assessment of the nonoperated root after apical surgery of the other root in mandibular molars: a 5-year follow-up study.
abstract: BACKGROUND
  If a surgical approach is chosen to treat a multirooted tooth affected by persistent periapical pathosis, usually only the affected roots are operated on. The present study assessed the periapical status of the nonoperated root 5 years after apical surgery of the other root in mandibular molars.
  
  
  METHODS
  Patients treated with apical surgery of mandibular molars with a follow-up of 5 years were selected. Patient-related and clinical parameters (sex, age, smoking, symptoms, and signs of infection) before surgery were recorded. Preoperative intraoral periapical radiographs and radiographs 5 years after surgery were examined. The following data were collected: tooth, operated root, type and quality of the coronal restoration, marginal bone level, length and homogeneity of the root canal filling, presence of a post/screw, periapical index (PAI) of each root, and radiographic healing of the operated root. The presence of apical pathosis of the nonoperated root was analyzed statistically in relation to the recorded variables.
  
  
  RESULTS
  Thirty-seven patients fulfilled the inclusion criteria. Signs of periapical pathosis in the nonoperated root 5 years after surgery (PAI ≥ 3) could be observed in only 3 cases (8.1%). Therefore, statistical analysis in relation to the variables was not possible. The PAI of the nonoperated root before surgery had a weak correlation with signs of apical pathosis 5 years after surgery.
  
  
  CONCLUSIONS
  Nonoperated roots rarely developed signs of new apical pathosis 5 years after apical surgery of the other root in mandibular molars. It appears reasonable to resect and fill only roots with a radiographically evident periapical lesion.
authors: Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, Bern, Switzerland. Electronic address: riccardo.kraus@zmk.unibe.ch.
authors: Riccardo D
authors: RD
authors: Kraus
authors: Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, Bern, Switzerland.
authors: Thomas
authors: T
authors: von Arx
authors: Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, Bern, Switzerland.
authors: David
authors: D
authors: Gfeller
authors: Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, Bern, Switzerland.
authors: Julien
authors: J
authors: Ducommun
authors: Department of Oral and Maxillofacial Surgery, Copenhagen University Hospital, Copenhagen, Denmark.
authors: Simon S
authors: SS
authors: Jensen
mesh_terms: D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D008963:Molar / Q000000981:diagnostic imaging / Q000601:surgery*; D010483:Periapical Diseases / Q000453:epidemiology* / Q000209:etiology; D012390:Root Canal Therapy / Q000009:adverse effects*; D014092:Tooth Root / Q000000981:diagnostic imaging / Q000601:surgery*
keywords: Apical surgery; long-term study; mandibular molars; nonoperated root; periapical index