Assessment Of Periapical Bone Healing After Endodontic Microsurgery Using Cone-Beam Computed Tomography

The purpose of this study was to evaluate the outcome of endodontic microsurgery (EMS) using Cone Bean Computed Tomography (CBCT) technology. The study also examined the success rate of EMS when bone graft and membranes used in patients who had undergone EMS for a bone defect using CBCT. It was hypothesized that patients who underwent the bone and membrane graft procedures would have better healing outcomes than those that did not undergo the bone and membrane grafts. The study was conducted using retrospective CBCT records of patients who had undergone endodontic microsurgery from October 2011 - July 2015 at a local Endodontic specialty practice. CBCT scans with a recall period of at least 6 months were selected. Preoperative and postoperative CBCTs were evaluated for healing outcomes. From the total surgeries performed in the clinic, 56 teeth (65 roots) were selected and were eligible for the study. EMS was divided into two groups dependent on the use of bone graft/membrane during the procedure. In Group A: bone graft/membrane was used during EMS. In Group B: bone graft/membrane was not used during EMS. Post-operative follow-up ranged from 6 months to 36 months and subjects were further divided into two sub-groups; one with a 6-12 month follow-up examination and one with a 13-36 month follow-up. Outcomes were categorized as complete healing, incomplete healing, unsatisfactory healing or persistent disease using the CBCT periapical index modified by Estrela in 2008. The results of the study failed to find a statistically significant difference. The reasons for this failure are suspected to be a small sample size and the inability to account for co-morbid factors that could have influenced healing after the EMS.