Conservative and surgical treatment approaches for periodontitis with emphasis on apical root resection: an evidence-based theoretical and statistical analysis
Keywords:
Periodontitis, conservative therapy, surgical treatment, apicoectomy, root-end resection, periodontal inflammation, bone regeneration, endodontic surgery, clinical outcomes, periapical lesions, evidence-based dentistry, tooth preservationAbstract
Periodontitis remains one of the most prevalent chronic inflammatory diseases of the oral cavity, frequently leading to progressive destruction of periodontal tissues and potential tooth loss if inadequately managed. The complexity of its pathogenesis necessitates a comprehensive therapeutic strategy that integrates both conservative and surgical modalities. Among surgical interventions, apical root resection (apicoectomy) occupies a pivotal role in the management of persistent periapical pathology unresponsive to conventional endodontic therapy. This article presents a theoretically grounded and statistically informed analysis of conservative and surgical approaches to periodontitis treatment, with particular emphasis on the indications, biological rationale, and clinical outcomes of apical root resection. Data synthesized from peer-reviewed articles, clinical trials, and doctoral dissertations demonstrate that combined treatment strategies significantly improve periodontal stability, reduce inflammatory burden, and enhance long-term tooth survival. Conservative measures, including mechanical debridement and antimicrobial control, serve as the foundation of therapy, whereas surgical techniques address anatomical and pathological complexities inaccessible through nonsurgical means. Reported success rates for apical root resection range between 70% and 95%, depending on case selection and operator expertise. The integration of evidence-based protocols, advanced diagnostic tools, and refined surgical techniques contributes to predictable outcomes. This review underscores the necessity of individualized treatment planning and multidisciplinary collaboration to optimize therapeutic success in periodontitis management.
References
1. American Association of Endodontists. (2020). Guide to clinical endodontics.
2. Patel, S., et al. (2019). Cone beam computed tomography in endodontics. International Endodontic Journal, 52(8), 1138–1152.
3. Siqueira, J. F., & Rôças, I. N. (2018). Clinical implications of microbiology in endodontics. Journal of Endodontics, 44(6), 857–870.
4. Peters, O. A. (2018). Current challenges and concepts in the preparation of root canal systems. Journal of Endodontics, 44(4), 559–567.
5. Krithikadatta, J., et al. (2014). Diagnostic accuracy of CBCT. Journal of Endodontics, 40(10), 1443–1447.
6. Hanahan, D., & Weinberg, R. A. (2011). Hallmarks of cancer: The next generation. Cell, 144(5), 646–674.
7. Hanahan, D. (2022). Hallmarks of cancer: New dimensions. Cancer Discovery, 12(1), 31–46.
8. Kumar, V., Abbas, A. K., Aster, J. C., & Turner, J. R. (2021). Robbins and Cotran Pathologic Basis of Disease (11th ed.). Elsevier.
9. Weinberg, R. A. (2014). The Biology of Cancer (2nd ed.). Garland Science.
10. DeVita, V. T., Lawrence, T. S., & Rosenberg, S. A. (2019). Cancer: Principles and Practice of Oncology (11th ed.). Wolters Kluwer.
6. Majno, G., & Joris, I. (2004). Cells, Tissues, and Disease. Oxford University Press.
7. Fink, S. L., & Cookson, B. T. (2005). Apoptosis, pyroptosis, and necrosis. Infection and Immunity, 73(4), 1907–1916.
8. Kerr, J. F. R., Wyllie, A. H., & Currie, A. R. (1972). Apoptosis. British Journal of Cancer, 26, 239–257.
1. Kroemer, G., et al. (2009). Classification of cell death. Cell Death & Differentiation, 16(1), 3–11.
10. Tait, S. W. G., & Green, D. R. (2010). Mitochondria and cell death. Cold Spring Harbor Perspectives in Biology, 2(9), a004671.
11. Ergashev, B. (2025). Advances in oral health: Prevention, treatment, and systemic implications. American Journal of Education and Learning, 3(3), 1108–1114.
12. Hacker, G. (2000). The morphology of apoptosis. Cell and Tissue Research, 301(1), 5–17.
13. Leist, M., & Jäättelä, M. (2001). Four deaths and a funeral. Nature Reviews Molecular Cell Biology, 2, 589–598.
14. Ergashev, B. (2025). Psychological support for cancer patients. ИКРО журнал, 15(1), 164–167.
15. Thompson, C. B. (1995). Apoptosis in development. Science, 267(5203), 1456–1462.
16. Ergashev, B. J. Oglu. (2025). Kennedy classification: Its significance. Tabib, 1(1), 1–7.
17. Adams, J. M., & Cory, S. (2007). Bcl-2-regulated apoptosis. Oncogene, 26, 1324–1337.
18. Fulda, S., & Debatin, K. M. (2006). Extrinsic apoptosis pathways. Oncogene, 25, 4798–4811.
19. Ergashev, B. (2025). Etiology and pathogenesis of acute periodontitis. Modern Science and Research, 4(5), 596–601.
21. Ergashev, B. (2025). The impact of energy drink consumption on the development and mineralization of teeth in adolescents. Академические исследования в современной науке, 4(31), 52–55.
24. Ergashev, B. (2025). Optimizing non-removable orthodontic treatment through individualized therapeutic programs for irreversible malocclusions. Естественные науки в современном мире, 4(7), 60–62.
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