Predictors of clinical outcomes in endodontic microsurgery: a systematic review and metaanalysis
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
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.
Giornale Italiano di Endodonzia has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.