Abstract
Periapical surgery is an important treatment alternative in the presence of a large periapical cyst. To achieve regeneration and optimal healing of the bone different bone substitutes can be used. A 25 year old male patient reported with the chief complaint of mobile teeth in maxillary anterior tooth region with 21 labially placed. He had a history of trauma 5 years back. The clinical and radiographic diagnosis of infected periapical cyst with 21,22; Endodontic treatment was performed with 21, 22 followed by periapical curettage. Platelet rich fibrin (PRF) was mixed with Metronidazole gel and used as a regenerative biomaterial in the periapical defect. 6 months follow up shows satisfactory healing and regeneration of periapical region. There is considerable clinical interest in using PRF in combination with Metronidazole Gel. In conclusion, the results of the present study indicate that metronidazole gel along with PRF has a beneficial effect on healing of periapical defects.
 Keywords: Growth factor, Platelet rich fibrin, Regeneration.
Highlights
The purpose of periapical surgery is to Completely remove all pathological tissue from the lesion.[1]Regeneration of periapical bone defects endure to present formid able challenges to the endodontists.[2]
Regenerative periapical surgery using Platelet rich fibrin (PRF) and Metronidazole Gel has been attempted to overcome the disadvantage of unreliable repair in conventional surgery and achieve optimal and accelerated soft- and hard tissue healing
PRF is a matrix of autologous fibrin, in which are embedded a large quantity of platelet and leukocyte cytokines during centrifugation
Summary
The purpose of periapical surgery is to Completely remove all pathological tissue from the lesion (root canal, soft tissue and bone).[1]. In cases of large periapical boned effects or through and through lesions, conventional surgery results in less predictable healing with extensive fibrous. Platelet rich fibrin (PRF) was evolved in France by Choukroun J et al, 2001. It is a second generation platelet concentrate extensively used to accelerate hard and soft tissue healing. The drug may be of use in cases of chronic progressive periodontitis where anaerobes are involved as pathogens.[7]. In this case, Regenerative periapical surgery using PRF and Metronidazole Gel has been attempted to overcome the disadvantage of unreliable repair in conventional surgery and achieve optimal and accelerated soft- and hard tissue healing
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