Over Ten-Year Survival Rates of Radicular Cyst-Causing Teeth and Factors Affecting Long-Term Outcomes With Apical Microsurgery: A Single-Centre Retrospective Analysis

Purpose This study aimed to evaluate the long-term efficacy and identify prognostic factors influencing the survival of teeth with radicular cysts treated by apical microsurgery. Methods A total of 212 teeth from 152 patients with histopathologically confirmed radicular cysts who underwent apical microsurgery at Gunma University Hospital between 2009 and 2021 were included. Treatment outcomes were classified as "success" if the treated tooth was preserved and "failure" if the tooth was extracted. Clinical variables showing significant differences in univariate analysis were included in a logistic regression model using forward selection, with treatment outcome as the dependent variable, to identify independent prognostic factors. Results The cumulative success rates at two, five, and 12 years were 93.5%, 80.2%, and 76.2%, respectively. Arch type, tooth position, periodontal pocket depth, multiple root canal treatments, apicomarginal bone defects, and perilesional sclerotic signs showed significant differences between the success and failure groups. Multivariate analysis revealed that periodontal pocket depth, apicomarginal bone defects, and tooth position were independent prognostic factors. Conclusion The long-term success of apical microsurgery for teeth with radicular cysts is adversely affected by the presence of periodontal pockets ≥ 4 mm, apicomarginal bone defects, and involvement of molars.