Outcomes of clinical studies of periapical procedures (parendodontic surgery): a systematic review

• Autor(a) principal: Almeida, Alberto Paulo Conceição de
• Data de Publicação: 2023
• Outros Autores: Gusmões, Vinicius de Aguiar, Foresto, Wolney Gabriel dos Passos, Castro, Fábio Pereira Linhares de
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: MedNEXT Journal of Medical and Health Sciences
• Texto Completo: https://mednext.zotarellifilhoscientificworks.com/index.php/mednext/article/view/310
• topic: Periapical surgery; Parendodontic surgery; Apical lesions; Complications

Introduction: The attempt to contain microbial proliferation does not prove to be viable or solvable through coronary access, periapical or parendodontic surgery is indicated as a therapeutic complement. Periapical surgery is intended to provide healing to periradicular tissues, generating rehabilitation of dental function, which is indicated in cases such as retro filling and periradicular tissue repair. Objective: It was to carry out a systematic review to elucidate the main approaches to apical and periapical lesions and other complications through evidence from clinical studies of endodontic surgery. Methods: The systematic review rules of the PRISMA Platform were followed. The research was carried out from April to June 2023 in Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 127 articles were found, and  47 articles were evaluated in full and 18 were included and developed in this systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 13 studies with a high risk of bias and 21 studies that did not meet GRADE. Periapical surgery (parendodontic) is indicated in cases of persistent chronic periapical inflammation, with extensive apical radiolucent areas, restricted coronal access to the root apex, due to insufficient retrograde sealing or root pins that cannot be removed, perforation and fracture of the apical third of the root, in addition to pulpal calcifications in the root third, etc. Increasingly used to repair problems that were not resolved through conventional endodontic treatment and endodontic retreatment, parendodontic surgery with retro-preparation and retro-filling, using appropriate materials and techniques, was efficient for removing the etiological agent and obtaining periapical health. Paraendodontic surgery is an effective and conservative treatment option concerning tooth extractions, and when performed correctly, with the aid of good materials such as MTA, it brings satisfactory results.