Treatment decisions in 330 cases referred for apical surgery

von Arx, Thomas; Roux, Eliane; Bürgin, Walter Bruno (2014). Treatment decisions in 330 cases referred for apical surgery. Journal of endodontics, 40(2), pp. 187-191. Elsevier 10.1016/j.joen.2013.10.024

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INTRODUCTION Apical surgery is an important treatment option for teeth with postendodontic apical periodontitis. However, little information is available regarding treatment planning in cases referred for apical surgery. This study evaluated the decisions made in such cases and analyzed the variables influencing the decision-making process. METHODS The study retrospectively assessed clinical and radiographic data of 330 teeth that had been referred to a specialist in apical surgery with regard to the treatment decisions made in those teeth. The clinical and radiographic variables were divided into subcategories to analyze which factors influenced the decision-making process. RESULTS The treatment decisions included apical surgery (59.1%), tooth extraction (25.8%), no treatment (9.1%), and nonsurgical endodontic retreatment (6.1%). Variables that showed statistically significant differences comparing treatment decisions among subcategories included probing depth (P = .001), clinical attachment level (P = .0001), tooth mobility (P = .012), pain (P = .014), clinical signs (P = .0001), length (P = .041) and quality (P = .026) of the root canal filling, and size (P = .0001) and location (P = .0001) of the periapical lesion. CONCLUSIONS This study shows that apical surgery was the most frequently made treatment decision in teeth referred to a specialist in apical surgery, but every fourth tooth was considered nonretainable and was scheduled for extraction. The data showed that the most common variables that influenced the decision to extract teeth were teeth with an increased probing depth and tooth mobility and teeth presenting with lesions not located at the apex.

Item Type:

Journal Article (Original Article)


04 Faculty of Medicine > School of Dental Medicine > Department of Oral Surgery and Stomatology

UniBE Contributor:

von Arx, Thomas; Roux, Eliane and Bürgin, Walter Bruno


600 Technology > 610 Medicine & health








Eveline Carmen Schuler

Date Deposited:

01 May 2014 08:43

Last Modified:

25 Jan 2017 12:15

Publisher DOI:


PubMed ID:


Uncontrolled Keywords:

Apical surgery, case selection, treatment planning




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