No clinical quantifiable benefits between non-surgical and surgical endodontic treatment

Debra M. Ferrailo, Analia Veitz-Keenan

Research output: Contribution to journalArticlepeer-review


Data sources The authors searched the following electronic databases: the Cochrane Oral Health Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL), Medline Ovid and Embase Ovid. The US National Registry of Clinical Trials (ClinicalTrials. gov) and the World Health Organisation (WHO) International Clinical Trials Registry Platform were searched for ongoing trials. There were no restrictions regarding language and publication date. The authors hand-searched the reference lists of the studies retrieved and key journals in the field of endodontics. Study selection Randomised controlled trials (RCTs) involving people with periapical pathosis including comparison of surgical versus nonsurgical treatment or different types of surgery. Outcome measures were healing of the periapical lesion assessed after one-year followup or longer, postoperative pain and discomfort and adverse effects such as tooth loss, mobility, soft tissue recession, abscess, infection, neurological damage or loss of root sealing material evaluated through radiographs. Data extraction and synthesis Two review authors independently extracted data from the included studies and assessed their risk of bias. Study authors were contacted to obtain missing information. The authors combined results of trials assessing comparable outcomes using the fixed-effect model, with risk ratios (RRs) for dichotomous outcomes and mean differences (MDS) for continuous outcomes, and 95% confidence intervals (CIs) and they used generic inverse variance for split-mouth studies. Results The review included 20 RCTs. Two trials at high risk of bias assessed surgery versus a non-surgical approach: root-end resection with root-end filling versus root canal retreatment. The other 18 trials evaluated different surgical protocols.

Original languageEnglish
Pages (from-to)75-76
Number of pages2
JournalEvidence-Based Dentistry
Issue number3
StatePublished - 27 Oct 2017
Externally publishedYes


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