Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
BMC Oral Health
Published in: BMC Oral Health 1/2021

01-12-2021 | Digital Volume Tomography | Research

Microsurgical endodontic treatment of the upper molar teeth and their relationship with the maxillary sinus: a retrospective multicentric clinical study

Authors: S. Taschieri, B. Morandi, M. Giovarruscio, L. Francetti, A. Russillo, S. Corbella

Published in: BMC Oral Health | Issue 1/2021

Login to get access

Abstract

Purpose

To assess the clinical and radiographic success rate of microsurgical endodontic treatment of upper molar teeth in relationship with the maxillary sinus, with 12 months follow-up.

Methods

Patients treated with microsurgical endodontic treatment of upper molar teeth in the period between 2017 and 2019 were recruited from two dental clinics according to specific selection criteria. The outcomes were determined based on clinical and radiographic results taken three, six and 12 months post-operatively, compared with those taken immediately before and after surgery. Clinical and radiographic outcomes were recorded. The distance between the most apical part of the root and of the lesion to the maxillary sinus was measured on CBCT images before the surgery. Patient-related outcomes were recorded.

Results

Out of 35 patients evaluated, 21 were selected according with the selection criteria for a total of 27 roots and 29 canals treated. After 12 months, 18 patients showed a complete healing whereas three demonstrated incomplete healing. Consequently, the success rate in this study was 85.7% after one year. In 28.5% (6 patients) there was a perforation of the Schneiderian membrane that didn’t seem to affect the outcome. All patients kept the molar one year later. The pain level decreased significantly over the time during the first week after surgery.

Conclusion

Microsurgical Endodontic treatment of the upper molar teeth should be considered a valid and predictable treatment option even in case of Schneiderian membrane perforation. Future clinical studies with a larger sample size are needed to compare the results obtained.
Literature
1.
Schilder H. Cleaning and shaping the root canal. Dent Clin North Am. 1974;18:269–96.PubMed
2.
Gutmann JL, Harrison JW. Surgical endodontics. Boston: Blackwell Scientific Publications; 1991.
3.
Carr G, Bentkover S. Surgical endodontics. In: Cohen S, Burns R, editors. Pathways of the pulp. 7th ed. St Louis: Mosby Inc; 1998. p. 608–56.
4.
Cheung LK, Lam J. Apicectomy of posterior teeth: a clinical study. Aust Dent J. 1993;38(1):17–21.PubMedCrossRef
5.
Kim Y, Lee SJ, Woo J. Morphology of maxillary first and second molars analyzed by cone-beam computed tomography in a Korean population: variations in the number of roots and canals and the incidence of fusion. J Endod. 2012;38:1063–8.PubMedCrossRef
6.
7.
Bailey BJ. Head and neck surgery: otolaryngology. 2nd ed. Philadelphia: Lippincott-Raven Publishers; 1998. p. 418–20.
8.
Petruson B, Hansson HA, Karlsson G. Structural and functional aspects of cells in the nasal mucociliary system. Arch Otolaryngol. 1984;110:576–81.PubMedCrossRef
9.
10.
11.
12.
13.
14.
15.
Eberhardt JA, Torabinejad M, Christiansen EL. A computed tomographic study of the distances between the maxillary sinus floor and the apices of the maxillary posterior teeth. Oral Surg Oral Med Oral Pathol. 1992;73:345–6.PubMedCrossRef
16.
Kwak HH, Park HD, Yoon HR, Kang MK, Koh KS, Kim HJ. Topographic anatomy of the inferior wall of the maxillary sinus in Koreans. Int J Oral Maxillofac Surg. 2004;33:382–8.PubMedCrossRef
17.
Howe RB. First molar radicular bone near maxillary sinus: a comparison of CBCT analysis and gross anatomic dissection for small bony measurement. Oral Surg Oral Med Oral Pathol Oral Radiol Endodontol. 2009;108:264–9.CrossRef
18.
Georgescu CE, Rusu MC, Sandulescu M, Enache AM, Didilescu AC. Quantitative and qualitative bone analysis in the maxillary lateral region. Surg Radiol Anat. 2012;34:551–8.PubMedCrossRef
19.
Kang SH, Kim BS, Kim Y. Proximity of posterior teeth to the maxillary sinus and buccal bone thickness: a biometric assessment using cone-beam computed tomography. J Endod. 2015;41:1839–46.PubMedCrossRef
20.
Lavasani SA, Tyler C, Roach SH, McClanahan SB, Ahmad M, Bowles WR. Cone-beam computed tomography: anatomic analysis of maxillary posterior teeth: impact on endodontic microsurgery. J Endod. 2016;42:890–5.PubMedCrossRef
21.
Oberli K, Bornstein MM, von Arx T. Periapical surgery and the maxillary sinus: radiographic parameters for clinical outcome. Oral Surg Oral Med Oral Pathol Oral Radiol Endodontol. 2007;103:848–53.CrossRef
22.
Wallace JA. Transantral endodontic surgery. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1996;82:80–3.PubMedCrossRef
23.
Eberhardt JA, Torabinejad M, Christiansen EL. A computed tomographic study of the distances between the maxillary sinus floor and the apices of the maxillary posterior teeth. Oral Surg Oral Med Oral Pathol Oral Radiol Endodontol. 1992;73:345–6.CrossRef
24.
25.
26.
Low K, Dula K, Burgin W, von Arx T. Comparison of periapical radiography and limited cone beam tomography in posterior maxillary teeth referred for apical surgery. J Endod. 2008;34:557–62.PubMedCrossRef
27.
Patel S, Dawood A, Mannocci F, Wilson R, Pitt FT. Detection of periapical bone defects in human jaws using cone beam computed tomography and intraoral radiography. Int Endod J. 2009;42:507–15.PubMedCrossRef
28.
Cheung GSP, Wei WLL, McGrath C. Agreement between periapical radiographs and cone-beam computed tomography for assessment of periapical status of root filled molar teeth. Int Endod J. 2013;46:889–95.PubMedCrossRef
29.
Uraba S, Ebihara A, Komatsu K, Ohbayashi N, Okiji T. Ability of cone-beam computed tomography to detect periapical lesions that were not detected by periapical radiography. J Endod. 2016;42:1186–90.PubMedCrossRef
30.
Watzek G, Bernhart T, Ulm C. Complications of sinus perforations and their management in endodontics. Dent Clin N Am. 1997;41:563–83.PubMed
31.
Freedman A, Horowitz I. Complications after apicoectomy in maxillary premolar and molar teeth. Int J Oral Maxillofac Surg. 1999;28:192–4.PubMedCrossRef
32.
Rud J, Rud V. Surgical endodontics of upper molars: relation to the maxillary sinus and operation in acute state of infection. J Endod. 1998;24:260–1.PubMedCrossRef
33.
Lin L, Chance K, Shovlin F, Skribner J, Langeland K. Oroantral communication in periapical surgery of maxillary posterior teeth. J Endod. 1985;11:40–4.PubMedCrossRef
34.
Ericson S, Finne K, Persson G. Results of apicoectomy of maxillary canines, premolars and molars with special reference to oroantral communication as a prognostic factor. Int J Oral Surg. 1974;3:386–93.PubMedCrossRef
35.
Ioannides C, Borstlap WA. Apicoectomy on molars: a clinical and radiographical study. Int J Oral Surg. 1983;12:73–9.PubMedCrossRef
36.
Taschieri S, Torretta S, Corbella S, et al. Pathophysiology of sinusitis of odontogenic origin. J Investig Clin Dent. 2015;8:1–7.
37.
Jerome CE, Hill AV. Preventing root tip loss in the maxillary sinus during endodontic surgery. J Endod. 1995;21:422–4.PubMedCrossRef
38.
Hauman CHJ, Chandler NP, Tong DG. Endodontic implications of the maxillary sinus: a review. Int Endod J. 2002;35:127–41.PubMedCrossRef
39.
Park WB, Han JY, Kang P, Momen-Heravi F. The clinical and radiographic outcomes of Schneiderian membrane perforation without repair in sinus elevation surgery. Clin Implant Dent Relat Res. 2019;21:931–7.PubMedCrossRef
40.
Friedman S, Lustmann J, Shaharabany V. Treatment results of apical surgery in premolar and molar teeth. J Endod. 1991;17:30.PubMedCrossRef
41.
World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA. 2000;284:3043–5.
42.
Taschieri S, Corbella S, Tsesis I, Bortolin M, Del Fabbro M. Effect of guided tissue regeneration on the outcome of surgical endodontic treatment of through-and-through lesions: a retrospective study at 4-year follow-up. Oral Maxillofac Surg. 2011;15:153–9.PubMedCrossRef
43.
Molven O, Halse A, Grung B. Observer strategy and the radiographic classification of healing after endodontic surgery. Int J Oral Maxillofac Surg. 1987;16:432–9.PubMedCrossRef
44.
Molven O, Halse A, Grung B. Incomplete healing (scar tissue) after periapical surgery. Radiographic findings 8–12 years after treatment. J Endod. 1996;22:264–8.PubMedCrossRef
45.
Gutmann JL, Harrison JW. Success, failure, and prognosis in periradicular surgery. In: Gutmann JL, Harrison JW, editors. Surgical endodontics. Boston: Blackwell Scientific; 1991. p. 338–9.
46.
Zuolo ML, Ferreira MOF, Gutmann JL. Prognosis in periradicular surgery: a clinical prospective study. Int Endod J. 2000;33:91–8.PubMedCrossRef
47.
Kim MJ, Jung UW, Kim CS, et al. Maxillary sinus septa: prevalence, height, location, and morphology. A reformatted computed tomography scan analysis. J Periodontol. 2006;77:903–8.PubMedCrossRef
48.
Tsesis I, Faivishevsky V, Kfir A, Rosen E. Outcome of surgical endodontic treatment performed by a modern technique: a meta- analysis of literature. J Endod. 2009;35:1505–11.PubMedCrossRef
49.
Tsesis I, Rosen E, Schwartz-Arad D, Fuss Z. Retrospective evaluation of surgical endodontics treatment: traditional versus modern technique. J Endod. 2006;32:412–6.PubMedCrossRef
50.
Garcia B, Martorell L, Marti E, Penarrocha M. Periapical surgery of maxillary posterior teeth. A review of the literature. Med Oral Patol Oral Cir Bucal. 2006;11:E146–50.PubMed
51.
52.
Boucher Y, Matossian L, Riliard F, Machtou P. Radiographic evaluation of the prevalences and technical quality of root canal treatment in a French population. Int Endod J. 2002;35(3):229–38.PubMedCrossRef
53.
Friedman S. Considerations and concepts of case selection in the management of post-treatment endodontic disease (treatment failures). Endod Top. 2002;1:54–78.CrossRef
54.
Peters LB, Lindeboom JA, Elst ME, Wesselink PR. Prevalence of apical periodontitis relative to endodontic treatment in an adult Dutch population: a repeated cross-sectional study. Oral Surg Oral Med Oral Pathol Oral Radiol Endodontol. 2011;111(4):523–8.CrossRef
55.
Tavares PB, Bonte E, Boukpessi T, Siqueira JF, Lasfargues JJ. Prevalence of apical periodontitis in root canal-treated teeth from an urban French population: influence of the quality of root canal fillings and coronal restorations. J Endod. 2009;35(6):810–3.PubMedCrossRef
56.
Del Fabbro M, Corbella S, Sequeira-Byron P, Tsesis I, Rosen E, Lolato A, Taschieri S. Endodontic procedures for retreatment of periapical lesions. Cochrane Database Syst Rev. 2016;Issue 10. Art. No.: CD005511.
57.
Giannobile WV, Lang NP. Are dental implants a panacea or should we better strive to save teeth? J Dent Res. 2016;95(1):5–6.PubMedCrossRef
58.
Salvi GE, Mischler DC, Schmidlin K, Matuliene G, Pjetursson BE, Brägger U, Lang NP. Risk factors associated with the longevity of multi-rooted teeth. Long-term outcomes after active and supportive periodontal therapy. J Clin Periodontol. 2014;41(7):701–7.PubMedCrossRef
59.
Klinge B, Flemming T, Cosyn J, De Bruyn H, Eisner BM, Hultin M, Isidor F, Lang NP, Lund B, Meyle J, et al. The patient undergoing implant therapy: summary and consensus statements. The 4th EAO consensus conference 2015. Clin Oral Implants Res. 2015;26(Suppl 11):64–7.PubMedCrossRef
Metadata
Title
Microsurgical endodontic treatment of the upper molar teeth and their relationship with the maxillary sinus: a retrospective multicentric clinical study
Authors
S. Taschieri
B. Morandi
M. Giovarruscio
L. Francetti
A. Russillo
S. Corbella
Publication date
01-12-2021
Publisher
BioMed Central
Published in
BMC Oral Health / Issue 1/2021
Electronic ISSN: 1472-6831
DOI
https://doi.org/10.1186/s12903-021-01610-3

Other articles of this Issue 1/2021

BMC Oral Health 1/2021 Go to the issue

Research

Nattokinase crude extract enhances oral mucositis healing

Research article

Impact of COVID-19 on Pakistani dentists: a nationwide cross sectional study

Research article

Molar incisor hypomineralization, prevalence, pattern and distribution in Sudanese children

Research

Prediction of the degree of pathological differentiation in tongue squamous cell carcinoma based on radiomics analysis of magnetic resonance images

Research article

Tooth and temporary filling material fractures caused by Cavit, Cavit W and Coltosol F: an in vitro study

Research article

Association between metabolic and hormonal profile, proinflammatory cytokines in saliva and gingival health in adolescent females with polycystic ovary syndrome