The aim of this systematic review was to compare the outcomes of two different approaches to endodontic surgery, traditional (TRS) or microsurgical (EMS).

The databases, Medline, PubMed and Embase were searched along with the following journals: Journal of Endodontics, International Endodontic Journal, Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology and Endodontics, Journal of Oral and Maxillofacial Surgery, International Journal of Oral and Maxillofacial Surgery.  Longitudinal studies published in English, French, German, Italian, or Spanish, with a minimum follow-up of 6 months were included. Assessment and data abstraction was carried out independently. Weighted pooled success rates and relative risk assessment between TRS and EMS were calculated and a meta-analysis was carried out using a random effects model.

Twenty one studies were included. Weighted pooled success rates calculated from extracted raw data showed 59% positive outcome for TRS (95% confidence interval, 0.55-0.6308) and 94% for EMS (95% confidence interval, 0.8889-0.9816). This difference was statistically significant (P < .0005). The relative risk ratio showed that the probability of success for EMS was 1.58 times the probability of success for TRS.

They concluded:

On the basis of the meta-analysis presented here, the probability of success for EMS proved significantly greater than the probability of success for TRS.

Setzer FC,Shah SB,Kohli MR,Karabucak B,Kim S. Outcome of endodontic surgery:a meta-analysis of the literature-part 1: Comparison of traditional root-end surgery and endodontic microsurgery. J Endod. 2010 Nov;36(11):1757-65.Epub 2010 Sep 17. Review. PubMed PMID: 20951283