Treatment outcome of surgical and non-surgical management of endodontic failures.

The principal modalities available to manage endodontic treatment failures are orthograde retreatment and apical surgery. Both modalities have specific advantages, clinical implications, and risks, and their selection involves a complex decision-making process. A review of the literature pertaining to the treatment outcome of each modality was undertaken to establish an objective reference for practitioners involved in the management of endodontic treatment failures. Based on a weighted average calculation of the results reported in the reviewed studies, the orthograde retreatment of teeth associated with apical periodontitis results in a success rate of 66 per cent, an uncertain healing rate of 11 per cent, and a failure rate of 23 per cent. Apical surgery results in a success rate of 59 per cent, an uncertain healing rate of 22 per cent, and a failure rate of 19 per cent. These figures are discussed with reference to the characteristics of the reviewed studies. It appears that many of the reviewed studies have lesser relevance today, due to the current technical improvements in both treatment and modalities.