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The prognostic data in regards to Endodontic Microsurgery attests to the fact that microsurgical success rates are far superior than traditional surgery. At the same time, within the surgical technique, each step of the procedure is important to ensure successful outcome.
Incorporating microsurgical principles, the success rate of endodontic microsurgery has been reported by previous articles to be approximately 90%. However, some reports have demonstrated less favorable outcomes in the long term of more than 5 years.

This presentation is based on a 15-year clinical study of microsurgery at the Microscope Center, Department of Conservative Dentistry of Yonsei University, Korea, since 2001. It will critically review the short term and long term outcomes of endodontic microsurgery as well as the outcome of micro re-surgery. In our study 192 teeth were followed up every 6 months for 2 years and every year up to 10 years. Over the 5-year period, 172 (91.5%) were considered to be successes. The teeth classified as successes were evaluated up to 10 years, with a final follow-up rate of 60.5% (104 of 172 cases). Out of 104 followed-up cases, 97 cases were classified as success in the long term: 91 with complete healing and 6 with incomplete healing. The overall maintained success rate was 93.3%. Regarding micro re-surgery, 54 teeth requiring surgical retreatment were studied. 39 teeth (92.9%) had successful outcomes.

This lecture will also deal with the prognostic factors for clinical outcomes in microsurgery based on our clinical studies, especially periodontal involvement, bony defect and lesion size. The healing success rates of endodontic microsurgery will be compared for cases with lesions of endodontic origin and with cases of combined endodontic-periodontal origin. Effects of bone tissue deficiency and lesion size on the outcome will be discussed based on clinical studies of intraoperative measurements of bone defects and 3-dimentional analyses using cone-beam computed tomography.
Through this presentation, we aim to deliver the expectations and potential reasons for failure of endodontic microsurgery and re-surgery, and discuss the intraoperative variables such as use of magnification and illumination, periodontal involvement, root-end management techniques for a more successful outcome of endodontic microsurgery as a measure to save teeth.