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The effect of periapical lesion size on the success rate of different endodontic treatments: a systematic review and meta-analysis

Abstract

Introduction

This systematic review evaluated the effect of periapical lesion (PL) size on the success rate of different endodontic treatments, including root canal treatment (RCT), non-surgical retreatment (NSR), and apical surgery (AS).

Methods

Cohorts and randomized controlled trials investigating the outcomes of endodontic treatment of permanent teeth with PL and its size were identified electronically through Web of Science, MEDLINE, Scopus, and Embase databases. Two reviewers independently conducted the study selection, data extraction, and critical appraisal process. The quality of the included studies was evaluated using the Newcastle-Ottawa Scale and the 11-item Critical Appraisal Skills Program checklist for randomized controlled trials. The success rates of the endodontic treatments (small lesions and large lesions) were estimated using the rate ratios (RRs) with an associated 95% confidence interval (CI).

Results

Out of 44 included studies, 42 were cohort, and 2 were randomized controlled trials. Thirty-two studies had poor quality. For the meta-analysis, five studies in RCT, 4 in NSR, and 3 in AS were considered. The RR of the endodontic treatment success in PLs was 1.04 in RCT (95% CI, 0.99–1.07), 1.11 in NSR (95% CI, 0.99–1.24), and 1.06 in AS (95% CI, 0.97–1.16). Only sub-group analysis of long-term follow-up of RCT showed a significantly higher success rate in small lesions than in large lesions.

Conclusions

Considering the quality of studies and variation in outcomes and size classification, our meta-analysis demonstrated that the PL size had no significant effect on the success rate of different endodontic treatments.

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Data availability

The raw/processed data required to reproduce these findings can be shared after publication by request from the corresponding author.

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FS searched the databases. Searching databases was done by FS Screening of the articles, data extraction, and quality assessment was done by MB, FR, and ASM Meta-analysis was done by LFG. All authors have participated in writing the manuscript. Critical revision of the manuscript was done by ASM and OD. All authors have read and approved the final manuscript.

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Baseri, M., Radmand, F., Milani, A.S. et al. The effect of periapical lesion size on the success rate of different endodontic treatments: a systematic review and meta-analysis. Evid Based Dent 24, 43 (2023). https://doi.org/10.1038/s41432-023-00851-1

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