Treatment of Periapical Lesions using a Combination of Bone Graft and Platelet-rich Fibrin

Abstract

Cohn 1998 proposed periapical surgery as a predictable option when root canal treatment is either not possible or fails. Bone grafts and bone regeneration materials are being used in periapical surgery with varying degrees of success. Calcium phosphate biomaterials have excellent tissue compatibility and do not elicit any inflammation or foreign body response. However the key to tissue regeneration is to stimulate a cascade of healing events that can result in the completion of integrated tissue formation. This is possible only with the use of biological mediators as they induce bone regeneration by osteoinduction while grafts induce regeneration by osteoconduction. The need for these biological modulators led to the development of Platelet-Rich Fibrin PRF by Choukroun et al. in 2001. This clot combines many healing and immunity promoters present in the initial blood harvest. Its natural fibrin architecture seems responsible for a slow release of growth factors and matrix glycoproteins during ge7 days Dohan 2009. The objective of this case report was to evaluate the bone regeneration in endodontically induced periapical lesions using PRF in combination with synthetic TCPand calcium hydroxyapatite bone graft material for a period of 9 months.