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Avances en Odontoestomatología

On-line version ISSN 2340-3152Print version ISSN 0213-1285

Abstract

TORRA-MONENY, M et al. Periapical surgery and regeneration: systematic review. Av Odontoestomatol [online]. 2023, vol.39, n.5, pp.210-224.  Epub Dec 25, 2023. ISSN 2340-3152.

Introduction:

According to the literature, after a periapical surgery there usually remains a bone defect that may be regenerated or not. The aim of this review is to analyse whether bone regeneration associated with periapical surgery is favourable on the healing of different defects.

Material and Methods:

A systematic review was performed in Medline-Pubmed, Scopus and Cochrane. PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) criteria were considered. Randomized clinical trials, case-control, cohort and cross-sectional studies published between January 2011 and April 2022, that analyses the success of periapical surgery associated or not with different bone regeneration techniques, English or Spanish, humans and adults (≥ 16years) studies were included.

Results:

A total of eightreports were included. They evaluated 285 subjects, with 35 subjects that dropped out. Different types of lesions were analysed in each report: through-and-through lesions, apico-marginal lesions, and periapical lesions, except for one that compared all of them. Different kinds of bone regenerative materials were used. A range of success of between 81,6% and 93,7% of bone regeneration was achieved.

Discussion:

Improvements in augmentation equipment, instruments, and materials are the reason for the large success of periapical surgery. 3D images are useful to make a better diagnosis of the size and kind of the defect and, in this way, to plan the treatment considering the need to regenerate or not. Although the results remain uncertain, it seems that for through-and-thought and apico-marginal lesions, it is better to regenerate in contrast with periapical lesions.

Keywords : Periapical surgery; surgical endodontic treatment; apicoectomy; endodontic surgery; periradicular surgery; guided tissue regeneration; bone regeneration; bone grafts; membranes.

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