Современный взгляд на операцию резекции верхушки корня. Часть I: протокол апикальной микрохирургии

В представленном обзоре анализируются ключевые факторы, оказывающие влияние на долгосрочный результат апикальной микрохирургии, с опорой на данные актуальных научных публикаций. Спектр рассмотренных параметров включает: состояние периапикальных тканей, выбор дизайна разреза, а также особенности материалов для ретроградного пломбирования — все эти аспекты играют определяющую роль в прогнозировании результатов лечения. Цель. Провести комплексный анализ литературных источников с целью выявления факторов, влияющих на исход апикальной микрохирургии, и оценить их влияние на процессы заживления костной ткани и сохранения зуба. Поиск информации осуществлялся в англо- и русскоязычных базах данных eLIBRARY, PubMed, Scopus.

This review analyzes key factors influencing the long-term outcomes of apical microsurgery, drawing on data from current scientific publications. The range of parameters considered includes the condition of periapical tissues, the choice of incision design, and the characteristics of materials for retrograde filling — all of which play a decisive role in predicting treatment success. Objective. To conduct a comprehensive analysis of the literature to identify factors affecting the outcomes of apical microsurgery and to evaluate their impact on bone tissue healing and tooth preservation. The information search was performed using English- and Russian-language databases, including eLIBRARY, PubMed, and Scopus.

апикальная микрохирургия, резекция верхушки корня, периапикальные ткани, ретроградное пломбирование, зубосохраняющие операции.

apical microsurgery, root-end resection, periapical tissues, retrograde filling, tooth-preserving surgeries.

1. Блинова А.В., Румянцев В.А. Деструктивные поражения апикального периодонта: достижения фундаментальной и прикладной науки в современных подходах к решению проблемы // Наука молодых (Eruditio Juvenium). - 2021. - Том 9, № 3. - С. 471-480.
2. Abella, Francesc, Joan De Ribot, Guillermo Doria, Fernando Duran-Sindreu, and Miguel Roig. Applications of Piezoelectric Surgery in Endodontic Surgery: A Literature Review // Journal of Endodontics 40, no. 3 (March 2014): 325-32. https://doi.org/10.1016/j.joen.2013.11.014.
3. Alanezi, Amer Z., Jin Jiang, Kamran E. Safavi, Larz S.W. Spangberg, and Qiang Zhu. Cytotoxicity Evaluation of Endosequence Root Repair Material // Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology 109, no. 3 (March 2010): e122-25. https://doi.org/10.1016/j.tripleo.2009.11.028.
4. Corbella, Stefano, Silvio Taschieri, Ahmed Elkabbany, Massimo Del Fabbro, and Thomas Von Arx. Guided Tissue Regeneration Using a Barrier Membrane in Endodontic Surgery: A Comprehensive Review // Swiss dental journal SSO - Science and Clinical Topics 126, no. 1 (January 13, 2016): 13-25. https://doi.org/10.61872/sdj-2016-01-140.
5. Dapkute Ingrida, Georges Bandelac, Chafic Safi, and Frank Setzer. Periapical Wound Healing // Microsurgery in Endodontics, no. 1 (August 2017): 113-118. http://doi.org/10.1002/9781119412502.ch13.
6. Fahey, T., N. O’Connor, T.Walker, and D.ChinShong. Surgical Endodontics: A Review of Current Best Practice // Oral Surgery 4, no. 3 (August 2011): 97-104. https://doi.org/10.1111/j.1752-248X.2011.01127.x.
7. Flynn, Richard, Federico Foschi, Brian Maloney, Greg Creavin, and Henry F. Duncan. The Impact of Bone Grafting with/without Barrier Membrane Placement on the Outcome of Apical Surgery: A Systematic Review and Metaanalysis // International Endodontic Journal 57, no. 8 (August 2024): 1006-20. https://doi.org/10.1111/iej.14066.
8. Gonzales, Cleber Lorensini, Vinicius De Moraes Dolce, and Fábio Pereira Linhares De Castro. Major Aspects of Minimally Invasive Endodontic Surgery Using Microsurgery: A Systematic Review // MedNEXT Journal of Medical and Health Sciences 5, no. S3 (June 18, 2024). https://doi.org/10.54448/mdnt24S301.
9. Iqbal, Azhar, Osama Khattak, Haifa Ali Almutairi, Ibrahem Turki Almaktoom, Gharam Radhi A. Alanazi, Khalid Hussain Ali Alruwaili, Awsaf Murdhi Alruwaili, et al. Endodontic Surgery and Post-Treatment Apical Periodontitis: A Systematic Review // The Open Dentistry Journal 18, no. 1 (June 3, 2024): e18742106296829. https://doi.org/10.2174/0118742106296829240513095047.
10. Khater, Ahmad G.A., Faez Saleh Al-Hamed, Engie M. Safwat, Mehada M.A. Hamouda, Mohamed S.A. Shehata, and Antonio Scarano. Efficacy of hemostatic agents in endodontic surgery: a systematic review and network meta-analysis // Journal of Evidence Based Dental Practice 21, no. 3 (September 2021): 101540. https://doi.org/10.1016/j.jebdp.2021.101540.
11. Kim, Syngcuk, and Samuel Kratchman. Modern Endodontic Surgery Concepts and Practice: A Review // Journal of Endodontics 32, no. 7 (July 2006): 601-23. https://doi.org/10.1016/j.joen.2005.12.010.
12. Pinto, Diogo, Andréa Marques, Joana F. Pereira, Paulo J. Palma, and João Miguel Santos. Long-Term Prognosis of Endodontic Microsurgery - A Systematic Review and Meta-Analysis // Medicina 56, no. 9 (September 3, 2020): 447. https://doi.org/10.3390/medicina56090447.
13. Ribeiro, Mariana Lourenço, Letycia Santos Bersaneti, and Fábio Pereira Linhares De Castro. Major Factors for the Effectiveness of Apical Endodontic Microsurgery: A Systematic Review // MedNEXT Journal of Medical and Health Sciences 5, no. 1 (January 5, 2024). https://doi.org/10.54448/mdnt24105.
14. Safi, Chafic, Meetu R. Kohli, Samuel I. Kratchman, Frank C. Setzer, and Bekir Karabucak. 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 // Journal of Endodontics 45, no. 7 (July 2019): 831-39. https://doi.org/10.1016/j.joen.2019.03.014.
15. Setzer, Frank C., and Samuel I. Kratchman. Present Status and Future Directions: Surgical Endodontics // International Endodontic Journal 55, no. S4 (October 2022): 1020-58. https://doi.org/10.1111/iej.13783.
16. Von Arx, Thomas, Miguel Peñarrocha, and Storgård Jensen. Prognostic Factors in Apical Surgery with Root-End Filling: A Meta-Analysis // Journal of Endodontics 36, no. 6 (June 2010): 957-73. https://doi.org/10.1016/j.joen.2010.02.026.
17. Yoo, Yeon-Jee, Dong-Won Kim, Hiran Perinpanayagam, Seung-Ho Baek, Qiang Zhu, Kamran Safavi, and Kee-Yeon Kum. Prognostic Factors of Long-Term Outcomes in Endodontic Microsurgery: A Retrospective Cohort Study over Five Years // Journal of Clinical Medicine 9, no. 7 (July 13, 2020): 2210. https://doi.org/10.3390/jcm9072210.
References:
1. Blinova A.V., Rumyantsev V.A. Destructive lesions of apical periodontitis: achievements of fundamental and applied science in modern approaches to solving the problem Nauka molodykh (Eruditio Juvenium) 9, no. 3 (September 30, 2021): 471-80. https://doi.org/10.23888/HMJ202193471-480.
2. Abella, Francesc, Joan De Ribot, Guillermo Doria, Fernando Duran-Sindreu, and Miguel Roig. Applications of Piezoelectric Surgery in Endodontic Surgery: A Literature Review // Journal of Endodontics 40, no. 3 (March 2014): 325-32. https://doi.org/10.1016/j.joen.2013.11.014.
3. Alanezi, Amer Z., Jin Jiang, Kamran E. Safavi, Larz S.W. Spangberg, and Qiang Zhu. Cytotoxicity Evaluation of Endosequence Root Repair Material // Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology 109, no. 3 (March 2010): e122-25. https://doi.org/10.1016/j.tripleo.2009.11.028.
4. Corbella, Stefano, Silvio Taschieri, Ahmed Elkabbany, Massimo Del Fabbro, and Thomas Von Arx. Guided Tissue Regeneration Using a Barrier Membrane in Endodontic Surgery: A Comprehensive Review // Swiss dental journal SSO - Science and Clinical Topics 126, no. 1 (January 13, 2016): 13-25. https://doi.org/10.61872/sdj-2016-01-140.
5. Dapkute Ingrida, Georges Bandelac, Chafic Safi, and Frank Setzer. Periapical Wound Healing // Microsurgery in Endodontics, no. 1 (August 2017): 113-118. http://doi.org/10.1002/9781119412502.ch13.
6. Fahey, T., N. O’Connor, T.Walker, and D.ChinShong. Surgical Endodontics: A Review of Current Best Practice // Oral Surgery 4, no. 3 (August 2011): 97-104. https://doi.org/10.1111/j.1752-248X.2011.01127.x.
7. Flynn, Richard, Federico Foschi, Brian Maloney, Greg Creavin, and Henry F. Duncan. The Impact of Bone Grafting with/without Barrier Membrane Placement on the Outcome of Apical Surgery: A Systematic Review and Metaanalysis // International Endodontic Journal 57, no. 8 (August 2024): 1006-20. https://doi.org/10.1111/iej.14066.
8. Gonzales, Cleber Lorensini, Vinicius De Moraes Dolce, and Fábio Pereira Linhares De Castro. Major Aspects of Minimally Invasive Endodontic Surgery Using Microsurgery: A Systematic Review // MedNEXT Journal of Medical and Health Sciences 5, no. S3 (June 18, 2024). https://doi.org/10.54448/mdnt24S301.
9. Iqbal, Azhar, Osama Khattak, Haifa Ali Almutairi, Ibrahem Turki Almaktoom, Gharam Radhi A. Alanazi, Khalid Hussain Ali Alruwaili, Awsaf Murdhi Alruwaili, et al. Endodontic Surgery and Post-Treatment Apical Periodontitis: A Systematic Review // The Open Dentistry Journal 18, no. 1 (June 3, 2024): e18742106296829. https://doi.org/10.2174/0118742106296829240513095047.
10. Khater, Ahmad G.A., Faez Saleh Al-Hamed, Engie M. Safwat, Mehada M.A. Hamouda, Mohamed S.A. Shehata, and Antonio Scarano. Efficacy of hemostatic agents in endodontic surgery: a systematic review and network meta-analysis // Journal of Evidence Based Dental Practice 21, no. 3 (September 2021): 101540. https://doi.org/10.1016/j.jebdp.2021.101540.
11. Kim, Syngcuk, and Samuel Kratchman. Modern Endodontic Surgery Concepts and Practice: A Review // Journal of Endodontics 32, no. 7 (July 2006): 601-23. https://doi.org/10.1016/j.joen.2005.12.010.
12. Pinto, Diogo, Andréa Marques, Joana F. Pereira, Paulo J. Palma, and João Miguel Santos. Long-Term Prognosis of Endodontic Microsurgery - A Systematic Review and Meta-Analysis // Medicina 56, no. 9 (September 3, 2020): 447. https://doi.org/10.3390/medicina56090447.
13. Ribeiro, Mariana Lourenço, Letycia Santos Bersaneti, and Fábio Pereira Linhares De Castro. Major Factors for the Effectiveness of Apical Endodontic Microsurgery: A Systematic Review // MedNEXT Journal of Medical and Health Sciences 5, no. 1 (January 5, 2024). https://doi.org/10.54448/mdnt24105.
14. Safi, Chafic, Meetu R. Kohli, Samuel I. Kratchman, Frank C. Setzer, and Bekir Karabucak. 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 // Journal of Endodontics 45, no. 7 (July 2019): 831-39. https://doi.org/10.1016/j.joen.2019.03.014.
15. Setzer, Frank C., and Samuel I. Kratchman. Present Status and Future Directions: Surgical Endodontics // International Endodontic Journal 55, no. S4 (October 2022): 1020-58. https://doi.org/10.1111/iej.13783.
16. Von Arx, Thomas, Miguel Peñarrocha, and Storgård Jensen. Prognostic Factors in Apical Surgery with Root-End Filling: A Meta-Analysis // Journal of Endodontics 36, no. 6 (June 2010): 957-73. https://doi.org/10.1016/j.joen.2010.02.026.
17. Yoo, Yeon-Jee, Dong-Won Kim, Hiran Perinpanayagam, Seung-Ho Baek, Qiang Zhu, Kamran Safavi, and Kee-Yeon Kum. Prognostic Factors of Long-Term Outcomes in Endodontic Microsurgery: A Retrospective Cohort Study over Five Years // Journal of Clinical Medicine 9, no. 7 (July 13, 2020): 2210. https://doi.org/10.3390/jcm9072210.