Use of higher magnification provides better outcomes in endodontic microsurgery

shutterstock_2296216-root canal xray

This systematic review is the second part of a review we first highlighted in Dental Elf on the 7th July. The  aim of this part was to assess whether root-end surgery techniques with microinstruments but only loupes or no visualization aids (contemporary root-end surgery [CRS]) compared with endodontic microsurgery using the same instruments and materials but with high-power magnification as provided by the surgical operating microscope or the endoscope (endodontic microsurgery [EMS]) produced better outcomes.

The databases, Medline, PubMed and Embase were searched along with the following journals: Journal of Endodontics, International Endodontic Journal, Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology and Endodontics, Journal of Oral and Maxillofacial Surgery, International Journal of Oral and Maxillofacial Surgery.  Longitudinal studies published in English, French, German, Italian, or Spanish, with a minimum follow-up of 6 months were included. Assessment and data abstraction was carried out independently. Weighted pooled success rates and relative risk assessment between CRS and EMS  overall as well as for molars, premolars, and anteriors were calculated and a meta-analysis was carried out using a random effects model.

14 studies were included  and they found

[table id=12 /]

Relative risk ratio analysis showed that the probability of success for EMS was 1.07 times the probability of success for CRS.

Seven studies provided information on the individual tooth type  there was a statistically significant difference   between two groups for molars (n = 193, P = .011) but not for premolars or anterior teeth

The authors concluded

The probability for success for EMS proved to be significantly greater than the probability for success for CRS, providing best available evidence on the influence of high-power magnification rendered by the dental operating microscope or the endoscope. Large-scale randomized clinical trials for statistically valid conclusions for current endodontic questions are needed to make informed decisions for clinical practice.

Setzer FC, Kohli MR, Shah SB, Karabucak B, Kim S.  Outcome of Endodontic Surgery: A Meta-analysis of the Literature—Part 2: Comparison of Endodontic Microsurgical Techniques with and without the Use of Higher Magnification. J of Endod

Share on Facebook Tweet this on Twitter Share on LinkedIn Share on Google+
Mark as read
Create a personal elf note about this blog
Profile photo of Derek Richards

Derek Richards

Derek Richards is a specialist in dental public health, Director of the Centre for Evidence-Based Dentistry and Specialist Advisor to the Scottish Dental Clinical Effectiveness Programme (SDCEP) Development Team. A former editor of the Evidence-Based Dentistry Journal and chief blogger for the Dental Elf website until December 2023. Derek has been involved with a wide range of evidence-based initiatives both nationally and internationally since 1994. Derek retired from the NHS in 2019 remaining as a part-time senior lecturer at Dundee Dental School until the end of 2023.

More posts - Website

Follow me here –