CLINICAL AND RADIOGRAPHIC OUTCOMES OF SURGICAL MANAGEMENT OF CHRONIC PERIAPICAL LESIONS IN MULTIROOTED TEETH/KLINICKI I RADIOGRAFSKI ISHOD HIRURSKOG LECENJA HRONICNIH PERIAPIKALNIH PROMENA VISEKORENIH ZUBA

Introduction. Chronic periapical lesion is a pathological process of the root apex and the surrounding alveolar bone. Granuloma, which is a term that usually describes a chronic periapical process, represents a mass of granulation tissue at the apex of a devitalized tooth. Such lesions are treated by conventional (endodontic) therapy or surgery. The aim of this study was to assess clinical and radiographic outcomes of surgical treatment of chronic periapical lesions in multirooted teeth. Material and Methods. This prospective study included 30 patients who underwent a standard Partsch surgical procedure. The root canals, without previous endodontic treatment, were obturated immidiately before surgery, or intraoperatively. The canals with short fillings or teeth with fixed prosthetics were retrogradely obturated. Zinc-phosphate cement condensed with gutta-percha cone was used for obturation. Evaluation of clinical outcomes was performed 6, 12 and 24 months after surgery, and radiographic outcomes after 12 and 24 months, respectively. Results. After surgery, a statistically significant improvements of treatment outcomes were observed between the follop-ups (p < 0.000). The overall success rate of chronic periapical lesions in multirooted teeth 24 months after surgery was 83.3% for clinical and 66.7% for radiographic outcomes. Conclusion. The results of clinical and radiographic parameters after surgical treatment outcomes in multirooted teeth were satisfying. Therefore, we may conclude that surgical treatment can be considered as a primary treatment option in the management of chronic periapical lesions. Key words: Periapical Diseases; Chronic Disease; Periapical Granuloma; Tooth Root; Treatment Outcome; Radiography, Dental; Root Canal Obturation; Oral Surgical Procedures Uvod. Hronicne periapikalne lezije predstavljaju patoloska stanja apeksa korena zuba i okolne kosti. Granulom je izraz koji se cesto koristi za hronicne periapikalne lezije, a odnosi se na granulaciono tkivo koje je u kontaktu sa apeksom avitalnog zuba. Ove promene lece se konzervativno (endodontski) i hirurski. Cilj ovog istrazivanja bila je analiza rezultata hirurskog lecenja hronicnih periapikalnih promena visekorenih zuba na osnovu klinickih i radioloskih parametara. Materijal i metode. Istrazivanje je bilo po tipu prospektivne studije kojom je obuhvaceno 30 pacijenata. Svi pacijenti operisani su standardnim hirurskim postupkom po Parcu (Partsch). Opturacija kanala korena zuba, koji nis