Treatment decisions in 330 cases referred for apical surgery.
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.
['von Arx|Thomas|T|', 'Roux|Eliane|E|', 'Bürgin|Walter|W|']
D000293:Adolescent D000328:Adult D000368:Aged D000369:Aged, 80 and over D001047:Apicoectomy D002648:Child D003657:Decision Making D005260:Female D006801:Humans D008297:Male D008875:Middle Aged D010347:Patient Care Planning D010483:Periapical Diseases D017622:Periodontal Attachment Loss D010514:Periodontal Pocket D011176:Post and Core Technique D016300:Radiography, Bitewing D012017:Referral and Consultation D019233:Retreatment D012189:Retrospective Studies D012389:Root Canal Obturation D012390:Root Canal Therapy D014081:Tooth Extraction D014086:Tooth Mobility D014098:Toothache D055815:Young Adult
Apical surgery treatment planning case selection