Endodontic micro-resurgery and guided tissue regeneration of a periapical cyst associated to recurrent root perforation: a case report
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Although the success rates of microsurgery and micro-resurgery are very high, the influence of a recurrent perforation combined with radicular cyst remains unclear. A 21-year-old white female patient had a history of root perforation in a previously treated right maxillary lateral incisor. Analysis using cone-beam computed tomography (CBCT) revealed an extensive and well-defined periapical radiolucency, involving the buccal and palatal bone plate. The perforation was sealed with bioceramic material (Biodentine) in the pre-surgical phase. In the surgical phase, guided tissue regeneration (GTR) was performed by combining xenograft (lyophilized bovine bone) and autologous platelet-rich fibrin applied to the bone defect. The root-end preparation was done using an ultrasonic tip. The retrograde filling was performed using a bioceramic material (Biodentine). Histopathological analysis confirmed a radicular cyst. The patient returned to her referring practitioner to continue the restorative procedures. CBCT analysis after 1-year recall revealed another perforation in the same place as the first intervention, ultimately treated by micro-resurgery using the same protocol with GTR, and a bioceramic material (MTA Angelus). The 2-year recall showed healing and bone neoformation. In conclusion, endodontic micro-resurgery with GTR showed long-term favorable results when a radicular cyst and a recurrent perforation compromised the success.
Abstract
Although the success rates of microsurgery and micro-resurgery are very high, the influence of a recurrent perforation combined with radicular cyst remains unclear. A 21-year-old white female patient had a history of root perforation in a previously treated right maxillary lateral incisor. Analysis using cone-beam computed tomography (CBCT) revealed an extensive and well-defined periapical radiolucency, involving the buccal and palatal bone plate. The perforation was sealed with bioceramic material (Biodentine) in the pre-surgical phase. In the surgical phase, guided tissue regeneration (GTR) was performed by combining xenograft (lyophilized bovine bone) and autologous platelet-rich fibrin applied to the bone defect. The root-end preparation was done using an ultrasonic tip. The retrograde filling was performed using a bioceramic material (Biodentine). Histopathological analysis confirmed a radicular cyst. The patient returned to her referring practitioner to continue the restorative procedures. CBCT analysis after 1-year recall revealed another perforation in the same place as the first intervention, ultimately treated by micro-resurgery using the same protocol with GTR, and a bioceramic material (MTA Angelus). The 2-year recall showed healing and bone neoformation. In conclusion, endodontic micro-resurgery with GTR showed long-term favorable results when a radicular cyst and a recurrent perforation compromised the success.
참고문헌 (31)
- Ricucci D, "Extraradicular infection as the cause of persistent symptoms: a case series", J Endod, 41, pp.265~273 (2015)
- Nair PN, "New perspectives on radicular cysts: Do they heal?", Int Endod J, 31, pp.155~160 (1998)
- Floratos S, "Modern endodontic microsurgery concepts: a clinical update", Dent Clin North Am, 61, pp.81~91 (2017)
- Niemczyk SP, "Essentials of endodontic microsurgery", Dent Clin North Am, 54, pp.375~399 (2010)
- Setzer FC, "Outcome of endodontic surgery: a meta-analysis of the literature--Part 2: comparison of endodontic microsurgical techniques with and without the use of higher magnification", J Endod, 38, pp.1~10 (2012)
- Kim D, "Outcome of endodontic micro-resurgery:retrospective study based on propensity score–matched survival analysis", J Endod, 44, pp.1632~1640 (2018)
- Song M, "Outcomes of endodontic micro-resurgery: a prospective clinical study", J Endod, 37, pp.316~320 (2011)
- Yoshikawa G, "Guided bone regeneration (GBR) using membranes and calcium sulphate after apicectomy: a comparative histomorphometrical study", Int Endod J, 35, pp.255~263 (2002)
- Lin L, "Guided tissue regeneration in periapical surgery", J Endod, 36, pp.618~625 (2010)
- Rankow HJ, "Endodontic applications of guided tissue regeneration in endodontic surgery", Oral Health, 86, pp.33~35 (1996)
- Tsesis I, "Diagnosis and treatment of accidental root perforations", Endod Topics, 13, pp.95~107 (2006)
- Estrela C, "Root perforations: a review of diagnosis, prognosis and materials", Braz Oral Res, 32, pp.e73~ (2018)
- Nakata TT, "Perforation repair comparing mineral trioxide aggregate and amalgam using an anaerobic bacterial leakage model", J Endod, 24, pp.184~186 (1998)
- Fuss Z, "Root perforations: classification and treatment choices based on prognostic factors", Endod Dent Traumatol, 12, pp.255~264 (1996)
- Silberman JJ, "Palatal root surgery of a maxillary molar using a piezosurgery transantral approach with simultaneous sinus lift grafting: a case report", Int Endod J, 54, pp.464~475 (2021)
- Nagendrababu V, "PRICE 2020 guidelines for reporting case reports in endodontics: a consensus-based development", Int Endod J, 53, pp.619~626 (2020)
- Pallarés-Serrano A, "Prognostic factors after endodontic microsurgery: a retrospective study of 111 cases with 5 to 9 years of follow-up", J Endod, 47, pp.397~403 (2021)
- Çalışkan MK, "Radiographic and histological evaluation of persistent periapical lesions associated with endodontic failures after apical microsurgery", Int Endod J, 49, pp.1011~1019 (2016)
- Trasatti C, "Increased Tgf-β1 production by rat osteoblasts in the presence of PepGen P-15 in vitro", J Endod, 30, pp.213~217 (2004)
- Bashutski JD, "Periodontal and endodontic regeneration", J Endod, 35, pp.321~328 (2009)
- Taschieri S, "Efficacy of guided tissue regeneration in the management of through-and-through lesions following surgical endodontics: a preliminary study", Int J Periodontics Restorative Dent, 28, pp.265~271 (2008)
- Taschieri S, "Efficacy of xenogeneic bone grafting with guided tissue regeneration in the management of bone defects after surgical endodontics", J Oral Maxillofac Surg, 65, pp.1121~1127 (2007)
- Dietrich T, "Periapical and periodontal healing after osseous grafting and guided tissue regeneration treatment of apicomarginal defects in periradicular surgery: results after 12 months", Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 95, pp.474~482 (2003)
- Dhiman M, "Effect of platelet-rich fibrin on healing of apicomarginal defects: a randomized controlled trial", J Endod, 41, pp.985~991 (2015)
- Karan NB, "Assessment of bone healing after mineral trioxide aggregate and platelet-rich fibrin application in periapical lesions using cone-beam computed tomographic imaging", Clin Oral Investig, 24, pp.1065~1072 (2020)
- Christensen CE, "Effect of lowering the pH of sodium hypochlorite on dissolving tissue in vitro", J Endod, 34, pp.449~452 (2008)
- Dohan DM, "Platelet-rich fibrin (PRF):a second-generation platelet concentrate. Part III: leucocyte activation: a new feature for platelet concentrates?", Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 101, pp.e51~e55 (2006)
- Soto-Peñaloza D, "Pain and quality of life after endodontic surgery with or without advanced plateletrich fibrin membrane application: a randomized clinical trial", Clin Oral Investig, 24, pp.1727~1738 (2020)
- Makhlouf M, "Sealing ability of calcium silicate-based materials in the repair of furcal perforations: a laboratory comparative study", J Contemp Dent Pract, 21, pp.1091~1097 (2020)
- da Fonseca TS, "Biodentine and MTA modulate immunoinflammatory response favoring bone formation in sealing of furcation perforations in rat molars", Clin Oral Investig, 23, pp.1237~1252 (2019)
- Coaguila-Llerena H, "Physicochemical properties of a bioceramic repair material - BioMTA", Braz Dent J, 31, pp.511~515 (2020)