Prognosis
Prognosis
Non-surgical root canal treatment achieves periapical healing in 85–95% of teeth without previous root canal treatment. For retreatment of previously filled teeth with persistent lesions, success rates range from 65–80%. Large lesions (>10mm) and true radicular cysts have lower healing rates with non-surgical treatment alone.
Periapical surgery achieves healing rates of 80–92% at 4-year follow-up for properly selected cases. Combination (orthograde retreatment + surgery) provides the highest success rates for previously treated teeth with large persistent lesions.
Teeth with CAP have comparable long-term survival to periodontally healthy teeth when adequately restored. The main causes of late failure are vertical root fracture (especially in over-instrumented, thin-walled roots), coronal leakage from inadequate restoration, and re-infection.