Success of Retrograde Filling Retreatments of Teeth with Intraradicular Restorations and Orthograde Restorations of Teeth with Periapical Lesions

Imtroduction: Endodontic treatment failure, primarily caused by persistent intracanal microorganisms, necessitates retreatment decisions between conservative orthograde approaches and surgical periapical interventions. Objective: To compare the clinical and radiographic success rates of retrograde filling following apicectomy in teeth with intraradicular restorations versus orthograde retreatment in teeth with periapical lesions. Materials and Methods: Forty-eight patients (27 males, 21 females) with endodontically treated teeth exhibiting periapical lesions were recruited at the Clinic for Oral Surgery, Tetovo. Participants were randomly allocated into two groups (n=24 each): Group 1 (control) received conventional apicectomy with orthograde filling material, while Group 2 (study) underwent surgical access with retrograde canal filling using amalgam or glass ionomer cement following 2.5-3 mm apical resection. Clinical and radiographic assessments were conducted at 6 and 12 months post-operatively Results: At 6 months, Group 2 demonstrated superior healing patterns with 14 complete healings versus 4 in Group 1, though differences were not statistically significant (p=0.03). At 12 months, Group 2 maintained advantages with 14 complete healings compared to 8 in Group 1, with no significant statistical difference (p=0.59). Overall success rate excluding uncertain cases was 79.16%, consistent with literature reporting 72-92% success rates. Conclusions: Retrograde filling with apicectomy represents a minimally invasive, effective approach for managing endodontic failures in teeth with intraradicular restorations, offering comparable or superior outcomes to conventional orthograde retreatment.