Endodontic micro-resurgery and guided tissue regeneration of a periapical cyst associated to recurrent root perforation: a case report

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...

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Main Authors: Fernando Córdova-Malca, Hernán Coaguila-Llerena, Lucía Garré-Arnillas, Jorge Rayo-Iparraguirre, Gisele Faria
Format: Article
Language:English
Published: Korean Academy of Conservative Dentistry 2022-11-01
Series:Restorative Dentistry & Endodontics
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Online Access:http://www.rde.ac/upload/pdf/rde-47-e35.pdf
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author Fernando Córdova-Malca
Hernán Coaguila-Llerena
Lucía Garré-Arnillas
Jorge Rayo-Iparraguirre
Gisele Faria
author_facet Fernando Córdova-Malca
Hernán Coaguila-Llerena
Lucía Garré-Arnillas
Jorge Rayo-Iparraguirre
Gisele Faria
author_sort Fernando Córdova-Malca
collection DOAJ
description 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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spelling doaj-art-ee2c65cf6a9249d5874b3336dd3f90772025-08-20T03:31:05ZengKorean Academy of Conservative DentistryRestorative Dentistry & Endodontics2234-76582234-76662022-11-01474e3510.5395/rde.2022.47.e351033Endodontic micro-resurgery and guided tissue regeneration of a periapical cyst associated to recurrent root perforation: a case reportFernando Córdova-Malca0Hernán Coaguila-Llerena1Lucía Garré-Arnillas2Jorge Rayo-Iparraguirre3Gisele Faria4Department of Endodontics, Cayetano Heredia Peruvian University (UPCH), Lima, PeruDepartment of Restorative Dentistry, Araraquara School of Dentistry, São Paulo State University (UNESP), Araraquara, SP, BrazilAcademic Department of Stomatological Clinic, Cayetano Heredia Peruvian University (UPCH), Lima, PeruAcademic Department of Stomatological Clinic, Cayetano Heredia Peruvian University (UPCH), Lima, PeruDepartment of Restorative Dentistry, Araraquara School of Dentistry, São Paulo State University (UNESP), Araraquara, SP, BrazilAlthough 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.http://www.rde.ac/upload/pdf/rde-47-e35.pdfapicoectomyguided tissue regenerationplatelet-rich fibrinretreatmentradicular cyst
spellingShingle Fernando Córdova-Malca
Hernán Coaguila-Llerena
Lucía Garré-Arnillas
Jorge Rayo-Iparraguirre
Gisele Faria
Endodontic micro-resurgery and guided tissue regeneration of a periapical cyst associated to recurrent root perforation: a case report
Restorative Dentistry & Endodontics
apicoectomy
guided tissue regeneration
platelet-rich fibrin
retreatment
radicular cyst
title Endodontic micro-resurgery and guided tissue regeneration of a periapical cyst associated to recurrent root perforation: a case report
title_full Endodontic micro-resurgery and guided tissue regeneration of a periapical cyst associated to recurrent root perforation: a case report
title_fullStr Endodontic micro-resurgery and guided tissue regeneration of a periapical cyst associated to recurrent root perforation: a case report
title_full_unstemmed Endodontic micro-resurgery and guided tissue regeneration of a periapical cyst associated to recurrent root perforation: a case report
title_short Endodontic micro-resurgery and guided tissue regeneration of a periapical cyst associated to recurrent root perforation: a case report
title_sort endodontic micro resurgery and guided tissue regeneration of a periapical cyst associated to recurrent root perforation a case report
topic apicoectomy
guided tissue regeneration
platelet-rich fibrin
retreatment
radicular cyst
url http://www.rde.ac/upload/pdf/rde-47-e35.pdf
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