J Korean Assoc Oral Maxillofac Surg.  2024 Jun;50(3):140-145. 10.5125/jkaoms.2024.50.3.140.

Assessing the efficacy of apicoectomy without retrograde filling in treating periapical inflammatory cysts

• Ku JK
• Jeon WY
• Ko SO
• Yoon JY

• KMID: 2557630
• DOI: http://doi.org/10.5125/jkaoms.2024.50.3.140

Abstract

Objectives
The necessity of retrograde filling after apicoectomy is controversial in cases of non-inflammatory cysts as opposed to bacteria-related periapical abscesses. This study aims to investigate whether the presence or absence of retrograde filling during apicoectomy has differential long-term prognostic implications between inflammatory and non-inflammatory cysts.
Materials and Methods
This retrospective study included patients who underwent tooth apicoectomy during jaw cyst enucleation between 2013 and 2022, and who underwent follow-up cone-beam computed tomography for at least 6 months. The prognosis of the tooth was evaluated during the follow-up period according to the cyst type, the presence or absence of retrograde filling, mandible or maxilla, and location.
Results
A total of 147 teeth was included in this study. All the operated teeth underwent preoperative root canal treatment by an endodontic specialist. Apicoectomy was performed for 119 inflammatory cysts and 28 non-inflammatory cysts. Retrograde filling was performed on 22 teeth with inflammatory cysts and 3 teeth with non-inflammatory cysts. All teeth survived the 3.5-year follow-up (range, 1.0-9.1 years). However, 1 tooth with an inflammatory cyst developed complications 1 year after surgery that required re-endodontic treatment.
Conclusion
The prognosis of a tooth treated by apicoectomy without retrograde filling during cyst enucleation is favorable, regardless of the cyst type.

Keyword

Radicular cyst; Odontogenic cyst; Retrograde filling; Root canal therapy; Prognosis

Figure

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  Fig. 1 Radiograph of a patient with a radicular cyst. A. Preoperative panoramic view. B. Postoperative panoramic view.

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  Fig. 2 Radiograph of a patient with an odontogenic keratocyst on the anterior maxilla. A. Initial panoramic view. B. Preoperative panoramic view after prior root canal therapy. C. Postoperative panoramic view.

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  Fig. 3 Postoperative radiograph of the patient from Fig. 1. A. Incomplete bone healing demonstrated on cone-beam computed tomography one year after the surgery. B. Gutta percha tracing from the gingival fistula.

Reference

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