Clinical and radiologic apicoectomized teeth . . re-examination of M. Mikkonen, D.D.S., A. Kullaa-Mikkonen, D.D.S., and R. Kotilainen, D.M.D., Kuopio, Finland DEPARTMENT OF DENTISTRY, UNIVERSITY OF KUOPIO Healing after periapical surgery was studied clinicaily and radiologically in 108 patients in whom apicoectomy had been performed on 174 teeth. Histologic diagnosis was used to determine healing results; teeth with periapical granuloma tend to heal less successfully than teeth showing inflammation or cysts. Postoperative treatment played an important role in the healing process. In making a prognosis one must include preoperative status (including periodontal status), operating method, and postoperative treatment. The age of the patient also has some influence on healing. S everal investigations of healing have been made after periapical surgery. Evaluation has usually been made with radiographs,‘e3 but results are not always comparable because the criteria have been poorly defined. In addition, postoperative observation time has varied from 6 months to 6 years. Results in apicoectomized teeth are available from some previ- ous investigations (Table I). Healing after periapical surgery dependson many factors. Possible healing factors mentioned in the literature are operating method, age of the patient, quality of the root filling, and extent of bone destruc- tion. Mattila and Altonen’ found that apicoecto- mized teeth with apical cysts tended to heal better than did those with periapical granuloma. Destruc- tion of the marginal bone buccally has also been mentioned in some investigation as a healing fac- tor.4*6 Resorption of alveolar crest and postoperative occlusal forces, however, have not been used to evaluate the prognosis after periapical surgery. The aim of the present study was to evaluate the influence of preoperative, operative, and postopera- tive factors in the healing process after periapical surgery. MATERIAL AND METHODS In 108 patients apicoectomy was performed on a total of 174 teeth. These patients were admitted for endodontic treatment to the Department of Dentist- ry, University of Kuopio, from 1977 to 1979. Their average age was 31.3 years, and the ages ranged from 16 to 57. There were forty-six men and sixty- 302 Fig. 1. Successful healing; radiolucent area has disap- peared and new periodontal space has been formed. Table 1. Results of root resections in some previous investigations I No. of Success rate Authors teeth examined (percent) Mattila and Altonen’ Nordenram and Svlrdstr6m4 Lehtinen and Aitasalo’ Rud et a1.2 Altonen and MattilaS Hirsch et al.’ 143 55 197 64 177 77.6 382 76 46* 71 572 46.1 *Molars