Introduction: The purpose of this randomized clinical trial was to evaluate healing after endodontic microsurgery (EMS) using mineral trioxide aggregate (MTA) versus EndoSequence root repair material (RRM; Brasseler, Savannah, GA) as root-end filling materials. Methods: Two hundred forty-three teeth with persistent or recurrent apical periodontitis were randomly assigned to either the MTA or RRM group. EMS was performed, and follow-up visits with clinical and radiographic investigation were scheduled at 6, 12, and 24 months with follow-up cone-beam computed tomographic (CBOT) imaging after 12 months. Results: One hundred twenty teeth with an average follow-up of 15 months were evaluated. The overall success rate was 93.3% for periapical (PA) evaluation and 85% for CBCT evaluation. The RRM group exhibited 92% and 84% success rates as assessed on PA and CBCT imaging, respectively. The MTA group exhibited 94.7% and 86% success rates as assessed on PA and CBCT imaging, respectively. No significant difference was observed between the 2 groups. Microsurgical classification, root canal filling quality, root-end filling material depth, and root fracture were found to be significant outcome predictors. Conclusions: EMS is a predictable procedure with successful outcome both 2-dimensional and 3-dimensional radiographic evaluation when RRM or MTA was used as the root-end filling material.

Chapter 3 Medication-Related Osteonecrosis of the Jaw and Endodontic Microsurgery Chafic Safi, Chafic SafiSearch for more papers by this authorBekir Karabucak, Bekir KarabucakSearch for more papers by this author Chafic Safi, Chafic SafiSearch for more papers by this authorBekir Karabucak, Bekir KarabucakSearch for more papers by this author Syngcuk Kim DDS, PhD, MD, Syngcuk Kim DDS, PhD, MDSearch for more papers by this authorSamuel Kratchman DMD, Samuel Kratchman DMDSearch for more papers by this author Book Author(s):Syngcuk Kim DDS, PhD, MD, Syngcuk Kim DDS, PhD, MDSearch for more papers by this authorSamuel Kratchman DMD, Samuel Kratchman DMDSearch for more papers by this author First published: 25 August 2017 https://doi.org/10.1002/9781119412502.ch3 AboutPDFPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShareShare a linkShare onFacebookTwitterLinked InRedditWechat Abstract Antiresorptive and antiangiogenic drugs are used to manage, prevent, and treat bone disease and cancer-related conditions. Despite their therapeutic effect, these drugs could induce medication-related osteonecrosis of the jaw (MRONJ). MRONJ is a serious condition where parts of the maxillary or mandibular bone get exposed with subsequent necrosis, infection, and even sequestration, leading to significant morbidity. Dental procedures such as endodontic microsurgery represent a major risk factor for MRONJ in patients being treated with antiresorptives and/or antiangiogenics. There are several risk factors for developing MRONJ while undergoing treatment with antiresorptive or antiangiogenic agents. These risk factors can be divided into three groups: medication-related factors, local factors and demographic and systemic factors. Still, it is important to establish a strategy to be able to offer safe treatment, especially when it comes to endodontic microsurgery. Once a patient is on antiresorptive or antiangiogenic therapy, the dental and endodontic treatment plan may change. Microsurgery in Endodontics, First Edition RelatedInformation