Nonsurgical root canal treatment or retreatment of teeth with large apical periodontitis lesions tied to favourable outcomes: Study

This study reported on the outcome of the nonsurgical root canal treatment/retreatment of teeth with large apical periodontitis lesions. The influence of some variables on the prognosis was also evaluated. The study included 199 teeth with large apical periodontitis lesions from 184 patients, treated/retreated by a single operator. Most teeth were managed in a single visit using NaOCl irrigation. Cases were followed up periodically from >1 to 8 years. Treatment/retreatment outcome was evaluated by clinical and radiographic/tomographic criteria and categorized as healed, healing, or diseased.

For statistical analysis, data were dichotomized so that healing cases were considered as success in a loose criterion or failure in a rigid one. Results: Clinical/radiographic analyses revealed that 67% of the initial treatment cases were classified as healed, 22.5% as healing, and 11% as diseased. Treatment success rates were 89% (loose) and 67% (rigid). Variables influencing the treatment outcome included previous abscess and antibiotic use, large lesions (≥10 mm), and a sinus tract. The median follow-up time for treatment was 31.5 months.

As for retreatment cases, 47% were healed, 32% were healing, and 21% were diseased. Retreatment success rates were 79% (loose) and 47% (rigid), in a median follow-up of 32 months. Cases evaluated by cone-beam computed tomography had lower healed rates. Findings demonstrate that high favourable outcome rates can be achieved by nonsurgical root canal treatment or retreatment of teeth with large apical periodontitis lesions.

Reference:

Artaza L, Campello AF, Soimu G, Alves FRF, Rôças IN, Siqueira JF Jr. Outcome of Nonsurgical Root Canal Treatment of Teeth With Large Apical Periodontitis Lesions: A Retrospective Study. J Endod. 2024 Aug 15:S0099-2399(24)00441-2. doi: 10.1016/j.joen.2024.08.003. Epub ahead of print. PMID: 39151889.