Guided-tissue regeneration in endodontic surgery

Aim. Endodontic surgery has for aim to treat bone lesions clue to dental-canal infections. The authors investigated the success rate of guided-tissue regeneration (GTR) in endodontic; Surgery for large periapical lesions. Methodology. Both bone defects, with eroded lingual/palatal and buccal cortex (two-wall defect: transosseous) ant] lesions with noneroded linguat/palatal cortex (four-wall defect) were assessed. All lesions had a diameter of least 10 mm. A total of 73 teeth in 55 patients were included according to specific selection criteria. Full mucoperiosteal tissue flap were used. A straight fissure bar in a hand-piece was positioned apically and 2.5 to 3 mm of the root-end were shaved away. Root-end cavities, 2.5 to 3 mm deep, were prepared with ultrasonic tips. [loot-ends were sealed using super EBA. The choice of using or not GTR associated with deproteinized bovine bone for each patient wax made by a cornputer-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 one-year follow-up. Results. Sixty-nine teeth were evaluated at one year follow-up. Twenty-six cases were transosseous lesions. At the one-year followup, 56 teeth had successfully healed (8.1.2%), healing was uncertain for 10 teeth and three were classified as failure. The cases classified as uncertain healing were scheduled for another follow-up three years later. Discussion. According to published data, GM as a complement of periapical surgery is not necessary for four-wall defects. However, it may be all indication for transosseous lesions. (C) 2008 Elsevier Masson SAS. All rights reserved.