Assessment of Treatment Outcomes in Grossly Decayed Posterior Teeth Managed With a Multidisciplinary Approach Involving Endodontics, Apical Surgery, and Prosthetic Rehabilitation: A Prospective Clinical Study.

BACKGROUND

Management of grossly decayed posterior teeth with deep subgingival caries and periapical pathology presents clinical challenges, often requiring either conventional endodontic therapy or surgical intervention. This study aimed to compare the treatment outcomes of these two approaches.

OBJECTIVE

To evaluate and compare the clinical efficacy of conventional endodontic therapy versus surgical intervention in the restoration of grossly decayed posterior teeth requiring crowns.

METHODS

This prospective, interventional clinical study included 30 patients aged 20-60 years with posterior teeth exhibiting pulp involvement, periapical lesions, and deep subgingival caries. Patients were randomly assigned to Group A (conventional root canal therapy with full-coverage crowns) or Group B (surgical intervention including apicoectomy or crown lengthening, followed by endodontic and prosthodontic rehabilitation). Clinical parameters such as pain, swelling, periapical healing, crown retention, functional outcomes, and patient satisfaction were assessed at baseline, 3, 6, and 12 months. Data were analyzed using SPSS v25.0 and Kaplan-Meier survival analysis.

RESULTS

Both treatment groups demonstrated significant clinical improvements over time. Group B showed superior periapical healing at 3 and 6 months; however, long-term outcomes at 12 months were comparable between groups. No significant differences were observed in pain reduction, crown retention, or patient satisfaction.

CONCLUSION

Both conventional and surgical approaches are effective for managing grossly decayed posterior teeth. Surgical intervention may offer short-term advantages in periapical healing, but long-term outcomes are similar, supporting tailored treatment based on individual clinical presentation.