Clinical ResearchClinical Outcomes after Apical Surgery on the Palatal Root of the Maxillary First Molar Using a Palatal Approach
Section snippets
Subjects
The Institutional Review Board of Yonsei University Health System approved the study protocol (IRB no. 2018-0106-001). We searched for patients who underwent apical surgery with a palatal approach on the palatal root of the maxillary first molar between March 2010 and September 2017 by a single operator (I. Y. Jung) at the Department of Conservative Dentistry, Yonsei University Dental Hospital, Seoul, Korea. This study included teeth with a chronic apical abscess or symptomatic apical
Results
The interexaminer agreement regarding periapical healing was 0.77, suggesting good agreement. Of the 46 treated cases, 11 were lost to follow-up. Thus, 35 cases were included in the analysis, and the recall rate was 76%. The follow-up period ranged from 1–8.1 years, with an average of 3.5 years (Table 1).
The included subjects were characterized by the variables listed in Table 2.
There were twice as many female patients (n = 23) as male patients (n = 12). Sixteen subjects were aged ≤40 years,
Discussion
In this study, we investigated 35 cases with apical surgery performed on the palatal root of the maxillary first molar using a palatal approach, with an average recall rate of 3.5 years. Thirty-two cases showed clinical and radiologic success, and only 3 teeth were extracted within 1 year of surgery. The success rate was 91.5%, which is similar to that observed in apical surgery performed on the other roots4,24,25. Palatal roots are predominantly straight, and their canals are single, round, or
Conclusion
Apical surgery on the palatal root of the maxillary first molar using a palatal approach may have an advantage in terms of accessibility or visibility compared with the buccal approach. Furthermore, use of the palatal approach led to a predictable and successful outcome, and complications arising from artery and nerve damage were minimal.
Acknowledgments
Sang-Hee Lee and Sin-Yeon Cho contributed equally to this study.
This research was supported by Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education (NRF-2017R1D1A1B03033315).
The authors deny any conflicts of interest related to this study.
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Cited by (6)
Selective Retreatment and Sinus Lift: An Alternative Approach to Surgically Manage the Palatal Roots of Maxillary Molars
2021, Journal of EndodonticsCitation Excerpt :However, this technique is also associated with several potential complications and challenges such as difficulty in positioning, lack of direct visualization during treatment, the need to raise 2 flaps if the buccal roots also require intervention, and the risk of injury to the greater palatine nerve and vessels during flap reflection and retraction. It has been shown by Lee et al6 that apical surgery performed on the palatal root from a palatal approach has a high success rate with minimal complications. However, the sample size of this study was small (35 teeth), and no information was provided regarding the clinical convenience of this technique.
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