Background Surgical endodontic procedures are usually performed to treat persistent apical periodontitis and periapical lesions. The final outcome of these operations depends on many factors and differs between patients. Recent advances in molecular biology have allowed the detection of changes in gene expression related to these operations. Methods and Materials A systematic search of the Medline and Cochrane databases and a gray literature search were performed. Results The studies highlighted the role of gene expression in inflammation, angiogenesis, and osteogenesis in endodontic treatments. Expression of TNF, and VTN was associated with inflammatory processes and delayed healing, while expression of RANKL/OPG, VEGFA, and ANGPT1 was linked to tissue remodeling and angiogenesis. Materials like MTA enhanced the expression of osteogenic genes (ALP, OCN) and anti-inflammatory markers (IL-4, IL-10). These findings suggest that these genes, combined with biomaterials, can serve as biomarkers and therapeutic targets to improve treatment outcomes. Conclusion In conclusion, the findings of the review support the use of specific genes as biomarkers for predicting healing outcomes, while the selection of retrograde filling materials, such as MTA and ERRM, can enhance bone regeneration and minimize inflammatory reactions in periapical tissues.
Kalogeris et al. (2025) studied this question.