Regenerative endodontic procedure combined with apical surgery of a necrotic permanent incisor with extensive periapical lesion using plasma rich in growth factors (PRGF): a case report with 6 years post-op evaluation using CBCT

• José-Francisco Gaviño-Orduña ^[1] ; Inés Fernández-Guallart ^[1] ; Javier Caviedes-Bucheli ^[2] ; Manuel Espadas-García ^[1] ; José López-López ^[3]
  1. [1] Universitat de Barcelona

     Universitat de Barcelona

     Barcelona, España

     
  2. [2] Pontífica Universidad Javeriana

     Pontífica Universidad Javeriana

     Colombia

     
  3. [3] PhD, MD, DDS, Dentist. University of Barcelona. Spain. Professor of Oral Patholoy. School of Dentistry, Barcelona University / Oral Health and Masticatory System Group (Bellvitge Biomedical Research Institute) IDIBELL, University of Barcelona, L’Hospitalet de Llobregat, Barcelona 08907, Spain

  Mostrar afiliaciones +
• Localización: Journal of Clinical and Experimental Dentistry, ISSN-e 1989-5488, Vol. 13, Nº. 6 (June), 2021, págs. 620-625
• Idioma: inglés
• Enlaces
  • Texto completo
• Resumen

  • The aim of this case report is to describe the step-by step and outcomes of a treatment approach which simultaneously combines a Regenerative Endodontic Procedure (REP) and apical surgery using PRGF as treatment of a post-traumatic necrotic permanent central incisor with extensive periapical lesion and undeveloped apex in a 16 years-old patient.

    A 16 years-old patient with an extensive periapical lesion in the maxillary central incisor was treated with a combination of REP and periapical surgery in the same visit. A Bi- antibiotic paste (BAP) was used to priorly disinfect the canal, which was posteriorly sealed with MTA placed over a PRGF clot at the same time that the periapical lesion was surgically debrided, removed and grafted, The radiographic and CBCT follow-up results showed a complete healing of the radiolucent lesion, which was replaced with bone-like tissue in two years and well preserved until six years later.

    A combined approach of a Regenerative Endodontic Procedure and apical surgery using PRGF may be a good treatment modality in cases of extensive periapical lesions in necrotic teeth with open apexes. PRGF has shown to act as an ideal autologous matrix because it is stable, provides growth factors and bioactive molecules, and stimulates collagen production, angiogenesis, and cell differentiation.