Reasons for apicectomies. A retrospective study.

A retrospective study was carried out to evaluate the clinical factors involved in deciding to perform apicectomies. Five hundred and seventeen teeth from 392 patients (211 women and 181 men) that had undergone apicectomy during the period from September, 1990 to December, 1992 were assessed using the patients' clinical records. The information recorded included the source of referral, the quality of preoperative root canal filling, the size of periradicular lesion, the type of the lesion (for biopsed lesions), the type of coronal and radicular restorations, and the different factors that influenced the decision to perform an apicectomy for each tooth. These factors were classified into technical and biological, and when they occurred together they were classified as combined. The decisions to perform apicectomies most commonly involved combined technical and biological factors. Biological factors alone only amounted to 35% of the total. Technical factors alone amounted to only 3% of the total. When all factors were considered, biological factors constituted 60%, whilst technical factors constituted 40%, of the total. The most common biological factors were persistent symptoms (54%), and continuing presence of a periradicular lesion (44%). The most common technical factors were post crown (60%) and crowned teeth without posts (31%). This study emphasised the need for a high standard of conventional root canal treatment in order to avoid surgical treatment.