Periapical surgery of 29 teeth. A comparison of conventional technique, microsaw and ultrasound.

Objectives: A clinical and radiological study is made of the results obtained with different periapical surgical techniques.

Material And Methods: Twenty-nine single-root teeth from 29 patients with periapical pathology following correct endodontic treatment were divided into three groups: (A) 10 patients in which rotary instruments were used to perform osteotomy, apicoectomy and cavity preparation; (B) 10 patients in which rotary instruments were used to perform osteotomy and apical resection, with ultrasound root-end cavity preparation; and (C) 9 patients in which microsaws were used for osteotomy, and ultrasound for cavity preparation. All teeth were filled with IRM. Clinical and radiological controls were made after 10 days, one and 6 months, and one year.

Results: Clinical success with the absence of symptoms was achieved in 17 cases (58.6%), while in 16 patients (55.2%) the X-ray images showed complete bony regeneration (complete healing). The clinical success rate after one year was 40%, 70% and 66.7% in groups A, B and C, respectively, while complete radiographic healing was recorded in 30%, 60% and 77.8%. There were three failures in group A, two in group C, and none in group B.

Conclusion: In conclusion, the best results were obtained when ultrasound was used for root-end cavity preparation.