OBJECTIVETo evaluate the therapeutic effect of teeth with large periapical lesions followed apical surgery.

METHODS59 patients (59 periapical lesions, 91 teeth) with large periapical lesions ranging in size from 6 mm to 21 mm in diameter were included in this study. All teeth were treated by root canal therapy and apical surgery, and the surgical procedure was completed with microsurgical technology and ultrasonic root-end preparation. The outcomes were evaluated clinically and radiographically at 1, 3, 6, 9, 12 and 24-month intervals, and the various factors which may affect the success rate were analyzed statistically.

RESULTS52 cases (88.1%) of 59 patients were considered success, 6 cases (10.2%) were considered failure, and 1 case (1.7%) was considered in progress. The success rate of elderly patients group (63.6%) was significantly lower than that of the youth group (87.5%) and middle-aged group (95.0%) (P = 0.037; P = 0.017). The success rate of molar group (75.0%) was significantly lower than that of the anterior group (92.6%) and the premolar group (90.0%) (P = 0.041, P = 0.047); however, there was no significant difference in the gender, the number of teeth invaded in lesions, the size of periapical lesion (P > 0.05).

CONCLUSIONIt is an effective therapy for the teeth with large periapical lesions by apical surgery after root canal treatment.