Periapical Healing, Event-Free Survival, and Associated Factors Following Non-Surgical Endodontic Retreatment: An Ambispective Cohort Study.

Authors

Adam Sgro, Maziar Ebrahimi Dastgurdi, Mahshid Sheikhnezami, Yazdan Sabet, Maryam Zanjir, Gevik Malkhassian, Bettina Basrani, Amir Azarpazhooh

Published in

Journal of endodontics. Jul 23, 2026. Epub Jul 23, 2026.

Abstract

Despite favourable outcomes of non-surgical endodontic retreatment (NS-ReTx), treatment decisions for previously treated posterior teeth with apical periodontitis remain inconsistent. This ambispective cohort study evaluated NS-ReTx outcomes in posterior teeth.
Permanent posterior teeth undergoing NS-ReTx in a residency program (2010-2023) with ≥24-month follow-up or an untoward event were included; otherwise, recall was attempted. Teeth were classified as healed, healing, or diseased. Periapical healing was defined using strict and loose criteria, and event-free survival as time to reintervention or last event-free follow-up. Analyses used logistic regression and Kaplan-Meier methods (α = 0.05).
Periapical healing analyses included 423 teeth (367 patients; median follow-up 3.7 years), comprising retrospectively (n=276; median follow-up 3.4 years) and prospectively (n=147; median follow-up 4.3 years) ascertained subgroups. Overall strict/loose periapical healing rates were 82.7%/89.8%, compared with 80.8%/87.0% and 86.4%/95.2% in the retrospective and prospective subgroups, respectively. Periapical healing rates were higher among teeth with longer follow-up. Absent or smaller preoperative periapical radiolucency (PARL) and adequate-quality final restorations were associated with improved strict periapical healing. Survival analyses included 480 teeth (417 patients). Kaplan-Meier estimated event-free survival was 96.5%, 94.5%, and 92.7% at 2, 4, and 6 years, respectively. The overall crude event-free survival rate was 93.3% with a median follow-up of 3.3 years.
Contemporary NS-ReTx in posterior teeth showed high periapical healing and event-free survival. Absent or smaller PARL and adequate-quality final restorations were associated with improved periapical healing. These findings should be interpreted considering potential selection bias from incomplete long-term follow-up.

PMID:
42492733
Bibliographic data and abstract were imported from PubMed on 24 Jul 2026.

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