Apical surgery: endoscopic findings at the resection level of 168 consecutively treated roots

Int Endod J. 2011 Apr;44(4):290-302. doi: 10.1111/j.1365-2591.2010.01811.x. Epub 2011 Jan 12.

Abstract

Aim: Endoscopic evaluation of the cut root face after root-end resection during apical surgery.

Methodology: Consecutive cases undergoing apical surgery from June 2006 to May 2008 were enrolled. After root-end resection, the cut root face was inspected with a rigid endoscope and the following findings were assessed: number of canals, presence of isthmus, presence and location of craze lines/cracks, frosted dentine, and gaps between root filling material and dentine. Craze lines/cracks, frosted dentine and gaps were further correlated with the age group of the patient (<45 vs. ≥ 45 years), the type of treated tooth and the presence or absence of a post/screw.

Results: The final material included 168 resected roots. The highest frequency of isthmuses was found in mesial roots of mandibular first molars (88.5%). A craze line/crack was seen in 9.5%, frosted dentine in 79.8% and gaps in 83.3% at the cut root faces. Significant differences were observed for the location of the microfindings at the resected root surfaces (buccal vs. mesial vs. lingual vs. distal, P > 0.0001). Premolars had significantly more craze lines/cracks than anterior teeth (P = 0.006) and molars (P = 0.000). Frosted dentine was significantly more frequently seen in premolars (P = 0.027) and molars (P = 0.001) compared to anterior teeth. The age groups and the presence or absence of a post/screw did not significantly influence the findings.

Conclusions: Frosted dentine and gaps were frequently observed with endoscopy at the resected root surfaces. The type of tooth appeared to affect the occurrence of a craze line/crack and of frosted dentine.

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Apicoectomy / adverse effects
  • Apicoectomy / methods*
  • Dental Pulp Cavity / anatomy & histology*
  • Dentin / pathology*
  • Endoscopy*
  • Female
  • Humans
  • Image Processing, Computer-Assisted
  • Male
  • Middle Aged
  • Photography
  • Post and Core Technique
  • Retrograde Obturation
  • Statistics, Nonparametric
  • Tooth Apex / anatomy & histology*
  • Tooth Apex / pathology
  • Tooth Apex / surgery
  • Tooth Fractures / etiology
  • Tooth Fractures / pathology
  • Ultrasonics
  • Young Adult