Technical and biological causes of periapical surgery: Retrospective analysis of 301 apical surgical cases

Abstract

Aim: Endodontic surgery is a treatment for persistent peri-radicular pathological conditions that do not improve after endodontic treatment. The aim of this study was to evaluate the quality of endodontic treatment, technical error types seen in root canals, and the periapical condition of the teeth in patients undergoing periapical surgery, and thus to analyze the reasoning behind the decision to perform periapical surgery. Methodology: Clinical and radiographic data of 301 periapical surgery cases were retrospectively evaluated in this study. The reasons for performing periapical surgery were classified as either technical or biological. Results: In this study, 51.8% of periapical surgery cases were related to biological factors, and 48.2% were related to technical factors. Maxillary anterior teeth were the most common teeth to undergo apical surgery, with a rate of 66.8%. The most common technical reasons for surgery were non-homogeneous filling (15.6%), underfilling (12%), and overfilling (9.6%). The most common biological reasons were cysts (30.2%), traumas (16.6%), and apical abscesses (5%). In 37.5% of cases, the diameter of the cystic lesion was 10 mm or larger. Conclusion: The number of cases of apical periodontitis is increasing in the Turkish community due to insufficiently filled root canals. Increasing the quality of the root canal treatments applied by dentists will reduce the need for periapical surgery by reducing the incidence of apical periodontitis.