{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T18:31:50Z","timestamp":1790101910826,"version":"4.0.1"},"reference-count":44,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2020,7,13]],"date-time":"2020-07-13T00:00:00Z","timestamp":1594598400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>The aim of this study was to analyze the long-term outcomes of endodontic microsurgeries in a cohort and identify their association with prognostic factors. A cohort of endodontic microsurgeries followed up periodically with complete clinical and radiographic records for at least 5 years were reviewed retrospectively. Their survival and healing status and profile characteristics were analyzed by Pearson chi-square test and logistic regression (\u03b1 = 0.05) to identify prognostic factors that influenced outcomes. Of 652 cases in the cohort, 225 (34.5%) were included. The mean follow-up period was 90.4 months (range, 60\u2013168 months). The long-term success rate was 80.5%, and the 5-year survival rate was 83.5%. Logistic regression showed higher success in anteriors compared to molars (OR = 5.405, (95% CI, 1.663\u201317.571; p = 0.005)) and in teeth with crown restorations (OR = 10.232, (95% CI, 3.374\u201331.024; p &lt; 0.001)). Conversely, lower success was found in teeth with periodontal disease (OR = 0.170, (95% CI, 0.032\u20130.900; p = 0.037)) and maxillary sinus involvement (OR = 0.187, (95% CI, 0.035\u20130.994; p = 0.049)). Endodontic microsurgery has a highly favorable long-term outcome. Tooth position, crown restoration, periodontal disease, and maxillary sinus involvement were identified as main prognostic factors.<\/jats:p>","DOI":"10.3390\/jcm9072210","type":"journal-article","created":{"date-parts":[[2020,7,14]],"date-time":"2020-07-14T11:03:23Z","timestamp":1594724603000},"page":"2210","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Prognostic Factors of Long-Term Outcomes in Endodontic Microsurgery: A Retrospective Cohort Study over Five Years"],"prefix":"10.3390","volume":"9","author":[{"given":"Yeon-Jee","family":"Yoo","sequence":"first","affiliation":[{"name":"Department of Comprehensive Treatment Center, Seoul National University Dental Hospital, Seoul 03080, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dong-Won","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Conservative Dentistry, Dental Research Institute, Seoul National University Dental Hospital, Seoul National University School of Dentistry, Seoul 03080, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6484-5932","authenticated-orcid":false,"given":"Hiran","family":"Perinpanayagam","sequence":"additional","affiliation":[{"name":"Schulich School of Medicine &amp; Dentistry, University of Western Ontario, London, ON N6A 5C1, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seung-Ho","family":"Baek","sequence":"additional","affiliation":[{"name":"Department of Conservative Dentistry, Dental Research Institute, Seoul National University Dental Hospital, Seoul National University School of Dentistry, Seoul 03080, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiang","family":"Zhu","sequence":"additional","affiliation":[{"name":"Division of Endodontology, Department of Oral Health and Diagnostic Sciences, School of Dental Medicine, University of Connecticut Health Center, Farmington, CT 06030, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kamran","family":"Safavi","sequence":"additional","affiliation":[{"name":"Division of Endodontology, Department of Oral Health and Diagnostic Sciences, School of Dental Medicine, University of Connecticut Health Center, Farmington, CT 06030, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3032-3498","authenticated-orcid":false,"given":"Kee-Yeon","family":"Kum","sequence":"additional","affiliation":[{"name":"Department of Conservative Dentistry, Dental Research Institute, Seoul National University Dental Hospital, Seoul National University School of Dentistry, Seoul 03080, Korea"},{"name":"National Dental Care Center for Persons with Special Needs, Seoul National University Dental Hospital for Persons with Special Needs, Seoul 03080, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2020,7,13]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"356","DOI":"10.1007\/s40496-019-00240-7","article-title":"Endodontic microsurgery: Outcomes and prognostic factors","volume":"6","author":"Kim","year":"2019","journal-title":"Curr. Oral Health Rep."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"601","DOI":"10.1016\/j.joen.2005.12.010","article-title":"Modern endodontic surgery concepts and practice: A review","volume":"32","author":"Kim","year":"2006","journal-title":"J. Endod."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1016\/S0099-2399(99)80398-7","article-title":"Short-term observation of the results of endodontic surgery with the use of a surgical operation microscope and Super-EBA as root-end filling material","volume":"25","author":"Rubinstein","year":"1999","journal-title":"J. Endod."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1757","DOI":"10.1016\/j.joen.2010.08.007","article-title":"Outcome of endodontic surgery: A meta-analysis of the literature\u2014Part 1: Comparison of traditional root-end surgery and endodontic microsurgery","volume":"36","author":"Setzer","year":"2010","journal-title":"J. Endod."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"569","DOI":"10.1007\/s00784-015-1398-3","article-title":"Outcome of nonsurgical retreatment and endodontic microsurgery: A meta-analysis","volume":"19","author":"Kang","year":"2015","journal-title":"Clin. Oral Investig."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1480","DOI":"10.1016\/j.joen.2018.06.019","article-title":"Tooth survival after surgical or nonsurgical endodontic retreatment: Long-term follow-up of a randomized clinical trial","volume":"44","author":"Riis","year":"2018","journal-title":"J. Endod."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1111\/j.1601-1546.2005.00187.x","article-title":"The prognosis and expected outcome of apical surgery","volume":"11","author":"Friedman","year":"2005","journal-title":"Endod. Top."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"700","DOI":"10.1067\/moe.2001.114828","article-title":"Comparison of clinical outcome of periapical surgery in endodontic and oral surgery units of a teaching dental hospital: A retrospective study","volume":"91","author":"Rahbaran","year":"2001","journal-title":"Oral Surg. Oral Med. Oral Pathol. Oral Radiol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"927","DOI":"10.1016\/j.joen.2011.04.005","article-title":"Prognostic factors for clinical outcomes in endodontic microsurgery: A retrospective study","volume":"37","author":"Song","year":"2011","journal-title":"J. Endod."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1071","DOI":"10.1016\/j.joen.2014.04.005","article-title":"Prognostic factors relating to the outcome of endodontic microsurgery","volume":"40","author":"Lui","year":"2014","journal-title":"J. Endod."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1055","DOI":"10.1016\/j.jfma.2018.10.019","article-title":"Outcome assessment of apical surgery: A study of 234 teeth","volume":"118","author":"Liao","year":"2019","journal-title":"J. Formos. Med. Assoc."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"957","DOI":"10.1016\/j.joen.2010.02.026","article-title":"Prognostic factors in apical surgery with root-end filling: A meta-analysis","volume":"36","author":"Penarrocha","year":"2010","journal-title":"J. Endod."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1016\/j.joen.2009.09.001","article-title":"Treatment outcome in endodontics: The Toronto study--phases 3, 4, and 5: Apical surgery","volume":"36","author":"Barone","year":"2010","journal-title":"J. Endod."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"570","DOI":"10.1016\/j.joen.2012.02.002","article-title":"Five-year longitudinal assessment of the prognosis of apical microsurgery","volume":"38","author":"Jensen","year":"2012","journal-title":"J. Endod."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1192","DOI":"10.1016\/j.joen.2012.06.014","article-title":"Long-term outcome of the cases classified as successes based on short-term follow-up in endodontic microsurgery","volume":"38","author":"Song","year":"2012","journal-title":"J. Endod."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"264","DOI":"10.1016\/S0099-2399(06)80146-9","article-title":"Incomplete healing (scar tissue) after periapical surgery\u2014Radiographic findings 8 to 12 years after treatment","volume":"22","author":"Molven","year":"1996","journal-title":"J. Endod."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"432","DOI":"10.1016\/S0901-5027(87)80080-2","article-title":"Observer strategy and the radiographic classification of healing after endodontic surgery","volume":"16","author":"Molven","year":"1987","journal-title":"Int. J. Oral Maxillofac. Surg."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1491","DOI":"10.1016\/j.joen.2013.08.026","article-title":"Prognostic factors of clinical outcomes in endodontic microsurgery: A prospective study","volume":"39","author":"Song","year":"2013","journal-title":"J. Endod."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"490","DOI":"10.1016\/j.joen.2013.10.034","article-title":"Comparison of clinical outcomes of endodontic microsurgery: 1 year versus long-term follow-up","volume":"40","author":"Song","year":"2014","journal-title":"J. Endod."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1016\/j.joen.2019.10.022","article-title":"Long-term success and survival of endodontic microsurgery","volume":"46","author":"Huang","year":"2020","journal-title":"J. Endod."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1007\/s12663-017-1008-9","article-title":"Clinical and radiographic outcomes of apical surgery: A clinical study","volume":"17","author":"Ogutlu","year":"2018","journal-title":"J. Maxillofac. Oral Surg."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1007\/s10006-019-00815-9","article-title":"Success rate 1 year after apical surgery: A retrospective analysis","volume":"24","author":"Sutter","year":"2020","journal-title":"Oral Maxillofac. Surg."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"2015","DOI":"10.1007\/s00784-013-1182-1","article-title":"Comparative assessment of the incidence of vertical root fractures between conventional versus surgical endodontic retreatment","volume":"18","author":"Karygianni","year":"2014","journal-title":"Clin. Oral Investig."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"546","DOI":"10.1016\/j.joen.2008.01.023","article-title":"Prospective clinical study evaluating endodontic microsurgery outcomes for cases with lesions of endodontic origin compared with cases with lesions of combined periodontal-endodontic origin","volume":"34","author":"Kim","year":"2008","journal-title":"J. Endod."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"474","DOI":"10.1067\/moe.2003.39","article-title":"Periapical and periodontal healing after osseous grafting and guided tissue regeneration treatment of apicomarginal defects in periradicular surgery: Results after 12 months","volume":"95","author":"Dietrich","year":"2003","journal-title":"Oral Surg. Oral Med. Oral Pathol. Oral Radiol. Endod."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Guess, G., and Kratchman, S. (2017). Maxillary posterior surgery, the sinus, and managing palatal access. Microsurgery in Endodontics, John Wiley & Sons, Inc.","DOI":"10.1002\/9781119412502.ch16"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"694","DOI":"10.1016\/j.joen.2016.12.015","article-title":"Outcomes of endodontic microsurgery using a microscope and mineral trioxide aggregate: A prospective cohort study","volume":"43","author":"Wang","year":"2017","journal-title":"J. Endod."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1016\/j.joen.2019.11.010","article-title":"Retrospective analysis of root-end microsurgery outcomes in a postgraduate program in endodontics using calcium silicate-based cements as root-end filling materials","volume":"46","author":"Chan","year":"2020","journal-title":"J. Endod."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1011","DOI":"10.1111\/iej.12554","article-title":"Radiographic and histological evaluation of persistent periapical lesions associated with endodontic failures after apical microsurgery","volume":"49","author":"Caliskan","year":"2016","journal-title":"Int. Endod. J."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"178","DOI":"10.1016\/j.joen.2019.11.002","article-title":"Long-term follow-up for apical microsurgery of teeth with core and post restorations","volume":"46","author":"Truschnegg","year":"2020","journal-title":"J. Endod."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1632","DOI":"10.1016\/j.joen.2018.07.024","article-title":"Outcome of endodontic micro-resurgery: A retrospective study based on propensity score-matched survival analysis","volume":"44","author":"Kim","year":"2018","journal-title":"J. Endod."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"394","DOI":"10.1016\/j.joen.2018.12.015","article-title":"A 10-year follow-up study of 119 teeth treated with apical surgery and root-end filling with mineral trioxide aggregate","volume":"45","author":"Jensen","year":"2019","journal-title":"J. Endod."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1489","DOI":"10.1016\/j.joen.2014.03.006","article-title":"Influence of apical root resection on the biomechanical response of a single-rooted tooth: A 3-dimensional finite element analysis","volume":"40","author":"Jang","year":"2014","journal-title":"J. Endod."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"116","DOI":"10.15171\/joddd.2018.018","article-title":"Apical surgery failures: Extraction or re-surgery? Report of five cases","volume":"12","author":"Torul","year":"2018","journal-title":"J. Dent. Res. Dent. Clin. Dent. Prospects"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1417","DOI":"10.1111\/iej.13143","article-title":"Impact of systemic diseases and tooth-based factors on outcome of root canal treatment","volume":"52","author":"Laukkanen","year":"2019","journal-title":"Int. Endod. J."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1623","DOI":"10.1016\/j.joen.2017.05.013","article-title":"Healing of apical periodontitis after nonsurgical treatment in patients with type 2 diabetes","volume":"43","author":"Arya","year":"2017","journal-title":"J. Endod."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"258","DOI":"10.1016\/j.tripleo.2011.01.016","article-title":"Super-EBA and IRM as root-end fillings in periapical surgery with ultrasonic preparation: A prospective randomized clinical study of 206 consecutive teeth","volume":"112","author":"Abrahamsson","year":"2011","journal-title":"Oral Surg. Oral Med. Oral Pathol. Oral Radiol. Endod."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1111\/iej.12451","article-title":"The outcome of apical microsurgery using MTA as the root-end filling material: 2-to 6-year follow-up study","volume":"49","author":"Tekin","year":"2016","journal-title":"Int. Endod. J."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"631","DOI":"10.1016\/0022-3913(85)90008-3","article-title":"Endodontically treated teeth as abutments","volume":"53","author":"Sorensen","year":"1985","journal-title":"J. Prosthet. Dent."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1175","DOI":"10.1016\/j.jdent.2013.07.018","article-title":"Multifactorial risk assessment for survival of abutments of removable partial dentures based on practice-based longitudinal study","volume":"41","author":"Tada","year":"2013","journal-title":"J. Dent."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"402","DOI":"10.1016\/j.joen.2018.11.002","article-title":"Periapical microsurgery: A 4-dimensional analysis of healing patterns","volume":"45","author":"Crossen","year":"2019","journal-title":"J. Endod."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"831","DOI":"10.1016\/j.joen.2019.03.014","article-title":"Outcome of endodontic microsurgery using mineral trioxide aggregate or Root Repair Material as root-end filling material: A randomized controlled trial with cone-beam computed tomographic evaluation","volume":"45","author":"Safi","year":"2019","journal-title":"J. Endod."},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Antal, M., Nagy, E., Sanyo, L., and Braunitzer, G. (2020). Digitally planned root end surgery with static guide and custom trephine burs: A case report. Int. J. Med. Robot, e2115.","DOI":"10.1002\/rcs.2115"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1397","DOI":"10.1016\/j.joen.2019.07.010","article-title":"Endodontic microsurgery using dynamic navigation system: A case report","volume":"45","author":"Gambarini","year":"2019","journal-title":"J. Endod."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/9\/7\/2210\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T09:50:40Z","timestamp":1760176240000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/9\/7\/2210"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,7,13]]},"references-count":44,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2020,7]]}},"alternative-id":["jcm9072210"],"URL":"https:\/\/doi.org\/10.3390\/jcm9072210","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,7,13]]}}}