Restorative Dentistry and Endodontics

  • 제47권4호
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  • Pages.35.1-35.9
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  • 2022
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  • 2234-7658(pISSN)
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  • 2234-7666(eISSN)
대한치과보존학회 (The Korean Academy of Conservative Dentistry)
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Endodontic micro-resurgery and guided tissue regeneration of a periapical cyst associated to recurrent root perforation: a case report

  • Fernando Cordova-Malca (Department of Endodontics, Cayetano Heredia Peruvian University (UPCH)) ;
  • Hernan Coaguila-Llerena (Department of Restorative Dentistry, Araraquara School of Dentistry, Sao Paulo State University (UNESP)) ;
  • Lucia Garre-Arnillas (Academic Department of Stomatological Clinic, Cayetano Heredia Peruvian University (UPCH)) ;
  • Jorge Rayo-Iparraguirre (Academic Department of Stomatological Clinic, Cayetano Heredia Peruvian University (UPCH)) ;
  • Gisele Faria (Department of Restorative Dentistry, Araraquara School of Dentistry, Sao Paulo State University (UNESP))
  • 투고 : 2022.03.01
  • 심사 : 2022.05.22
  • 발행 : 2022.11.30
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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.

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과제정보

This research was supported by Fundacao de Amparo a Pesquisa do Estado de Sao Paulo (FAPESP) (grant number 18/24662-6).

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