Endodontic surgery with guided tissue regeneration comparison with only flap closure. A Case Report

Aim. Endodontic surgery has for aim to treat bone lesions due to root canal infections. the aim of the present study was to evaluate the periapical healing of apical defects 24 months after periradicular surgery and guided tissue regeneration in a series of consecutively treated patients. Methods. 10 patients were treated with guided-tissue regeneration and 10 without biomaterial and membrane after surgery. Root-end cavities, 2.5 to 3 mm deep, were prepared with piezo-ultrasonic tips. Root-ends were sealed using Super EBA. the choice of using or not GTR associated with deproteinized bovine bone for each patient was made by a computer-generated randomized table. For cases allocated to the GTR group, the defect was filled with anorganic bovine-bone mineral and then covered with a resorbable collagen membrane. The outcome was assessed by clinical and radiographic evaluation at 24 months follow-up. Results. All patients were recalled after 1, 3, 6, 12 and 24 months. At the one-year follow-up all teeth had successfully healed, healing was uncertain for 1 tooth after 24 months and 3 were classified as failure Conclusions. GTR as a complement of periapical surgery is not necessary for four-wall defects. However, it may be an indication for transosseous lesions. Guided tissue regeneration treatment of apicomarginal defects yields good results in terms of periapical and periodontal healing and should be considered as an adjunct to periradicular surgery in such cases.