Outcomes of periradicular surgery in cases with apical pathosis and untreated canals

Objective. Surgical management is intended to eliminate or block infection originating in the root canals. The root end is customarily sealed to preve nt pathogenic products remaining in the root canal from reaching the perira dicular tissues. The purpose of this study was to evaluate the microbiologi c and radiographic outcomes of surgical treatment of periradicular pathosis associated with teeth with necrotic pulps. Study design. One tooth from each of 10 patients was root-end resected and root-end filled without prior root canal treatment One year postoperatively , the outcomes we're assessed radiographically and the root canals were sam pled for bacteria. Results. Radiographic examination showed complete or incomplete (scar tissu e) healing in 5 teeth and uncertain healing in the other 5 teeth. Bacteriol ogic samples from the root canals were positive in 9 of the 10 cases. Conclusions. In teeth with necrotic pulps, treatment of periradicular patho sis by surgery and root-end filling may show radiographic evidence of satis factory healing 1 year postoperatively. However, viable bacteria may persis t in the canals, constituting a potential risk factor for recurrence of per iradicular pathosis.