Clinical management of nonhealing periradicular pathosis - Surgery versus endodontic retreatment

Nonhealing periradicular pathosis associated with endodontically treated teeth is customarily managed by revision (retreatment). Root-end resection is less often the first choice of treatment. Objectives. This prospective randomized study compared the outcome of retreatment and surgical intervention in root canal treated teeth with nonhealing periradicular pathosis. Study design. One such tooth from each of 38 patients was randomly allotted to retreatment or root-end resection and root-end filling. Treatment outcome after 1 year was evaluated and compared clinically and radiographically. Results. The success rate for surgery was higher than for conventional retreatment, but the difference was not statistically significant. Conclusions. For management of nonhealing periradicular pathosis associated with root canal treated teeth, surgical intervention should be considered as an alternative to retreatment. In cases with a similar prognosis for both modes of treatment, the choice should be governed by consideration of intrinsic and extrinsic factors.