DOI
https://doi.org/10.25772/QX5J-Q874
Defense Date
2025
Document Type
Thesis
Degree Name
Master of Science in Dentistry
Department
Dentistry
First Advisor
Garry Myers, DDS
Second Advisor
Terence Imbery, DDS
Third Advisor
Caroline Carrico, PhD
Abstract
Objective: This study examines the pre-surgical clinical and radiographic characteristics that may influence the choice of apicoectomy over nonsurgical retreatment in a more detailed approach, focusing on the clinical factors that come into the evaluation phase. We hypothesize that there are certain patterns observed through a pre-operative CBCT that may impact the decision for surgical intervention. The study aims to assess patterns in the decision-making in surgical treatment planning.
Methods: Retrospective review analyzing 142 cases treated or planned for apicoectomy by VCU endodontic residents. Data collected from CBCT and PA radiographs included: restorations, quality of prior root canal treatment, presence and size of periapical lesions, posts, separated instruments, untreated canals, root curvature, cortical plate integrity, crestal bone status, resorption, and proximity to anatomical structures.
Results: Large periapical lesions and cases with cortical plate perforations were significantly associated with apicoectomies. Majority of cases had PAI scores of 4 or 5 with 76% of cases involving buccal cortical plate perforations. There was marginal significance associated between the quality of the root canal treatment and PAI scores (p=0.0847). Separated instruments was found in 4% of cases and not associated with larger lesion sizes.
Conclusion: Larger lesions, cortical plate perforations (specifically the buccal) were significant indicators that were common in cases treatment planned for apicoectomies. The presence of a post was seen in over one-third of cases. Separated instruments, untreated canals, vertical defects, approximation to IAN or mental foramen, resorption and moderate-severe root curvatures were not commonly associated with cases treatment planed for apicoectomies.
Rights
© The Author
Is Part Of
VCU University Archives
Is Part Of
VCU Theses and Dissertations
Date of Submission
4-30-2025