Page 128 - Demo

Chapter 7126Materials and MethodsPatient selectionPatients referred by their dentists for periapical surgery at the Department of Oral and Maxillofacial Surgery of Amstelland Hospital in Amstelveen, the Netherlands, during 2017 and 2018 were eligible for inclusion in this prospective study. The study was reviewed and approved by the institutional Medical Ethics Committee of the Academic Medical Centre of the University of Amsterdam and conducted in accordance with Good Clinical Practice and the Declaration of Helsinki, as amended in Somerset West, Republic of South Africa, in 1996. Patients were fully informed about the surgical procedure, postoperative care, follow-up examinations, and alternative treatment options. Each patient was informed that they could withdraw from the study at any time without consequences regarding their treatment. Inclusion and exclusion criteriaPatients with apical periodontitis in a root canal-treated tooth were included in this study. Asymptomatic patients aged ≥18 years and in good health (American Society of Anesthesiologists [ASA] I or II) who were willing to participate and able to read, understand, and answer the questionnaire were considered for inclusion if they had periapical periodontitis with no possibility of root canal retreatment or the ability to achieve better results with a nonsurgical approach. Patients underwent a clinical and radiographic examination, and a panoramic radiograph and periapical radiograph were taken. The tooth to be treated had to have an adequate final restoration without clinical evidence of coronal leakage. No acute symptoms were present, and the diameter of the periapical lesions had to be <10 mm as measured on the periapical radiograph.Exclusion criteria were other causes related to root pathology other than apical re-infection, such as root fractures, teeth with an inadequate coronal restoration, perforations and bone loss (periodontal pockets deeper than 7 mm), and defects of the buccal and lingual cortical bone, as suggested by Zuolo et al [18]. Other exclusion criteria were antibiotic prophylaxis, a history of a recent and/or symptomatic peptic ulcer, antiplatelet or anticoagulant therapy, pregnancy or lactation, recent (< 15 days) acute local infection before