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Periapical Surgery

Periapical Surgery. Thomas Dietrich. Changes of periodontal parameters following apical surgery: a prospective clinical study of three incision techniques T. von Arx, T. Vinzens-Majaniemi, W. Bürgin & S. S. Jensen Int Endod J 2007; 40: 959-969. Study design. Longitudinal Prospective

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Periapical Surgery

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  1. Periapical Surgery Thomas Dietrich

  2. Changes of periodontal parameters following apical surgery: a prospective clinical study of three incision techniques T. von Arx, T. Vinzens-Majaniemi, W. Bürgin & S. S. Jensen Int Endod J 2007; 40: 959-969.

  3. Study design • Longitudinal • Prospective • Observational • Cohort study • Patients with 238 teeth undergoing apical surgery from 2000 – 2004 Von Arx et al. Int Endod J 2007; 40: 959-969.

  4. Study flowchart Von Arx et al. Int Endod J 2007; 40: 959-969.

  5. Distribution of teeth per incision technique Von Arx et al. Int Endod J 2007; 40: 959-969.

  6. Distribution of teeth per restoration Von Arx et al. Int Endod J 2007; 40: 959-969.

  7. Changes (mean ± SD) of PD, GM, CAL by incision technique Von Arx et al. Int Endod J 2007; 40: 959-969.

  8. Conclusions • The intrasulcular incision demonstrated greater changes in the levels of the GM and the clinical attachment than the other incision techniques, meaning more recession of the GM and greater loss of attachment. Von Arx et al. Int Endod J 2007; 40: 959-969.

  9. Marginal incision Von Arx et al. Int Endod J 2007; 40: 959-969.

  10. Papilla-base incision Von Arx et al. Int Endod J 2007; 40: 959-969.

  11. Submarginal incision Von Arx et al. Int Endod J 2007; 40: 959-969.

  12. Criteria for success • For example (von Arx & Kurt 1999): • Pain score (0-3) • Clinical Score (0-3) • Healing classification: • Success/complete healing (>90% regeneration of bone & pain/clinical scores = 0) • Improvement/partial healing (50-90% regeneration of bone & pain/clinical scores = 0) • Failure/incomplete/uncertain healing (<50% regeneration of bone OR pain/clinical scores >0)

  13. Clinical and Radiographic Assessment of Various Predictors for Healing Outcome 1 Year After Periapical Surgery T. von Arx, S.S. Jensen, S. Hänni JEndod 2007; 33: 123-128.

  14. Study flowchart Von Arx et al . J Endod 2007; 33: 123-128.

  15. Results (example) Von Arx et al . J Endod 2007; 33: 123-128.

  16. “Conclusions” • In conclusion, case selection for periapical surgery should consider the clinical significance of prognostic variables • more studies are needed to evaluate the effect of multiple predictors on healing outcome after periapical surgery Von Arx et al . J Endod 2007; 33: 123-128.

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