(TC22) Outcome of Periapical Surgery in Mandibular Molars: A Review

Abstract: Periapical surgery is an established surgical procedure performed to eliminate persistent or recurrent periapical inflammation/infection after orthograde endodontic therapy. Although nonsurgical retreatment is considered the first treatment option for the management of persistent periapical periodontitis, clinical situations arise where periapical surgery may be a more appropriate modality. Performing apical surgical procedures on mandibular molars is often perceived as unpredictable and is avoided by many clinicians due to factors, such as anatomy, access, or patients' health. One of the most comprehensive papers analyzing different factors affecting success rates of periapical surgeries was published by Bliggernstorfer et al. in 2021. The purpose of this table clinic is to present a review of surgical considerations, variables, and factors that may influence healing, and evaluate the success rates of mandibular molar surgeries in literature. A search strategy with no date limit was conducted on PubMed, and 110 possible studies were identified. Although healing was evident in short-term follow-up from 1 to 5 years, success rates seem to decline after 5 years. Part of this may be due to a lack of research on long-term success. Understanding the importance of supporting variables and being able to predict the success of these surgeries is beneficial for both the clinician and the patient. Are new technologies increasing the success rate of mandibular molar apical surgery? More well-designed, high-level evidence outcome studies are needed to evaluate the long-term success of these procedures.