Predictors of clinical outcomes in endodontic microsurgery: a systematic review and metaanalysis

  • Claudia Garcia-Guerrero | ccgarciag@unal.edu.co Universidad Nacional de Colombia, School of Dentistry, Department of Basic Sciences and Oral Medicine, Division of Endodontics at Bogota, Bogota, Colombia.
  • Sara Quijano Guauque Universidad Nacional de Colombia, School of Dentistry, Department of Basic Sciences and Oral Medicine, Division of Endodontics at Bogota, Bogota, Colombia.
  • Nicolas Molano Department of Statistics, Centro de Estudio de Enfermedades Autoinmunes, School of Medicine and Health Sciences, Universidad del Rosario at Bogota, Bogota, Colombia.
  • Gerardo Antonio Pineda Universidad Nacional de Colombia, Statistics Department at Bogota, Colombia.
  • Javier L. Nino-Barrera Universidad Nacional de Colombia, School of Dentistry, Department of Basic Sciences and Oral Medicine, Division of Endodontics at Bogota, Bogota, Colombia.
  • Dairo Javier Marin-Zuluaga Dean Universidad Nacional de Colombia School of Dentistry at Bogota, Bogota, Colombia.

Abstract

The prevalence of recurrent periapical lesions has been reported between 43 and 65%, endodontic microsurgery (EM) is an alternative treatment option of recurrent periapical lesions. Aim: the aim of the present study was to systematically quantify the effects of the association ‘‘clinical factors/follow-up period’’ on EM outcomes. Methodology: Two researchers conducted a literature search from 2005 to 2015. Searched databases were MEDLINE, Evidence-based Endodontics, Cochrane Library, EMBASE, LILACS, SCIELO, Trip-Database. Tables of contents of endodontic journals and references listed on retrieved articles were searched as well. A residual heterogeneity test set at 95% confidence interval controlled sample variability of each study. Meta-regression estimated the factor/followup period on the outcomes of the ME. Results: 1242 articles were identified, 10 of which were included for meta-regression. On average, EM was 84.13% successful when evaluated from 1 to 6 years. The heterogeneity analysis (P = 0.87) established the total variability of 8% in reference to sample variability. It was determined that a loss of ‘‘Crestal Bone Height’’ >3 mm proportionally predicts, from the second year on, an increased risk of EM failure (OR = 1.33, 90%CI, 1.01—1.77; P = 0.09). Factors such as ‘‘retro-filling material’’ (P = 0.0002), ‘‘presurgical clinical signs’’ (P = 0.0116), and ‘‘dentinal root defects’’ (P = 0.0001) are considered significant risk factors for EM failure without association to time. Conclusions: EM could be considered clinically successful over time. The factor ‘‘crestal bone height’’ estimated a predictive and progressive association of healing from the second year on. Different root-end filling materials aside from MTA could be associated with EM failure, without association with follow-up periods.

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Published
2017-06-30
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Section
Original Articles
Keywords:
Periapical surgery, Endodontics, Microsurgery, Meta-analysis, Clinical factors
Statistics
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How to Cite
Garcia-Guerrero, C., Quijano Guauque, S., Molano, N., Pineda, G. A., Nino-Barrera, J. L., & Marin-Zuluaga, D. J. (2017). Predictors of clinical outcomes in endodontic microsurgery: a systematic review and metaanalysis. Giornale Italiano Di Endodonzia, 31(1), 2-13. https://doi.org/10.32067/gie.2017.31.01.02