Restorative Dentistry & Endodontics

Research Article

Impact of bacteriological testing using an anaerobic culture system on the success of non-surgical endodontic treatment: a retrospective study: Jun Nakanishi, Noriko Saito-Nakayama, Shizu Hirata-Tsuchiya, Daisuke Furutama, Ayaka Miyata-Arita, Tomoki Kawayanagi, Takuya Arita, Saki Nishihama, Tomoya Naruse, Wang Chutian, Song Bingxin, Naoki Sadaoka, Tomoki Kumagai, Kazuma Yoshida, Katsuhiro Takeda, Hideki Shiba; J Korean Acad Conserv Dent ;Published online July 16, 2026; DOI: https://doi.org/10.5395/rde.2026.51.e33 [Epub ahead of print]

Abstract PDF PubReader ePub: Objectives
Residual bacteria at the time of root canal obturation significantly influence endodontic treatment outcomes in teeth with apical periodontitis, and confirmation of bacterial elimination from the root canal prior to obturation may improve long-term prognosis. However, the contribution of root canal bacterial culture to treatment outcomes in teeth with infected root canals is debated. This study aimed to retrospectively evaluate treatment outcomes in cases in which root canal obturation was performed after confirming negative bacteriological test results.
Methods
The medical records of patients with apical periodontitis or pulp necrosis in whom root canal obturation was performed after confirming a negative bacteriological test result using an anaerobic culture system at the Department of Endodontics and Operative Dentistry at Hiroshima University Hospital between April 1, 2015, and September 30, 2023, were retrospectively reviewed. Treatment outcomes were assessed by comparing dental radiographs obtained before treatment with those obtained during the follow-up, ranging from 3 to 24 months after root canal obturation.
Results
This retrospective study included 284 teeth from 218 patients, and the success rate was 89.1%. Tooth type, number of root canals, type of treatment, preoperative radiolucency around the root apex, preoperative root canal obturation material, dentist experience, and postoperative extent of root canal obturation material did not significantly affect treatment outcomes.
Conclusions
The findings of this retrospective study suggest that infection control incorporating bacteriological examination of root canals using an anaerobic culture system may contribute to a high success rate of nonsurgical endodontic treatment, regardless of other prognostic factors.

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Review Article

Success and failure of endodontic microsurgery: Minju Song, Euiseong Kim; J Korean Acad Conserv Dent 2011;36(6):465-476. Published online November 30, 2011; DOI: https://doi.org/10.5395/JKACD.2011.36.6.465

In current endodontic practice, introduction of operating microscope, ultrasonic instruments, and microinstruments has induced a big change in the field of surgical retreatment. In this study, we aimed to offer key steps of endodontic microsurgery procedure compared with traditional root-end surgery, and to evaluate factors influencing success and failure based on published articles.

Endodontic microsurgery is a surgical procedure performed with the aid of a microscope, ultrasonic instruments and modern microsurgical instruments. The microscope provides magnification and illumination - essential for identifying minute details of the apical anatomy. Ultrasonic instruments facilitate the precise root-end preparation that is within the anatomical space of the canal. Modern endodontics can therefore be performed with precision and predictability, thus eliminating the disadvantages inherent in traditional periapical surgery such as large osteotomy, beveled apicoectomy, inaccurate root-end preparation and the inability to observe isthmus.

Factors influencing the outcomes of endodontic microsurgery may be diverse, but standardization of procedures can minimize its range. Among patient and tooth-related factors, periodontal status and tooth position are known to be prognostic, but there are only few articles concerning this matter. High-evidence randomized clinical trials or prospective cohort studies are needed to confirm these findings.

Citations

Citations to this article as recorded by

Treatment-Related Factors Affecting the Success of Endodontic Microsurgery and the Influence of GTR on Radiographic Healing—A Cone-Beam Computed Tomography Study
Daniel Bieszczad, Jarosław Wichlinski, Tomasz Kaczmarzyk
Journal of Clinical Medicine.2023; 12(19): 6382. CrossRef
Factors Affecting the Success of Endodontic Microsurgery: A Cone-Beam Computed Tomography Study
Daniel Bieszczad, Jaroslaw Wichlinski, Tomasz Kaczmarzyk
Journal of Clinical Medicine.2022; 11(14): 3991. CrossRef
Comparison of Clinical Outcomes of Endodontic Microsurgery: 1 Year versus Long-term Follow-up
Minju Song, Taekjin Nam, Su-Jung Shin, Euiseong Kim
Journal of Endodontics.2014; 40(4): 490. CrossRef
The Influence of Bone Tissue Deficiency on the Outcome of Endodontic Microsurgery: A Prospective Study
Minju Song, Sahng Gyoon Kim, Su-Jung Shin, Hyeon-Cheol Kim, Euiseong Kim
Journal of Endodontics.2013; 39(11): 1341. CrossRef
Prognostic Factors of Clinical Outcomes in Endodontic Microsurgery: A Prospective Study
Minju Song, Sahng Gyoon Kim, Seung-Jong Lee, Baekil Kim, Euiseong Kim
Journal of Endodontics.2013; 39(12): 1491. CrossRef
Is stopping of anticoagulant therapy really required in a minor dental surgery? - How about in an endodontic microsurgery?
Yong-Wook Cho, Euiseong Kim
Restorative Dentistry & Endodontics.2013; 38(3): 113. CrossRef

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