2D and 3D radiographic outcome assessment of the effect of guided tissue regeneration using resorbable collagen membrane in the healing of through‐and‐through periapical lesions – a randomized controlled trial

Parmar, Parul; Dhamija, Ritika; Tewari, Sanjay; Sangwan, Pankaj; Gupta, Ambika; Duhan, Jigyasa; Mittal, Shweta

doi:10.1111/iej.13098

Cited by 29 publications

(66 citation statements)

References 21 publications

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“…2017, Parmar et al . 2019) that fulfilled the inclusion criteria were included in the meta‐analysis. References listed in the eligible articles were examined, and no additional eligible studies were identified.…”

Section: Resultsmentioning

confidence: 99%

“…Parmar et al . (2019) analysed the clinical and radiographic results of 30 participants with through‐and‐through periapical lesions. The results at the 12‐month follow‐up revealed that both the intervention and the control groups exhibited clear reductions in lesion sizes.…”

Section: Discussionmentioning

confidence: 99%

“…The results at the 12‐month follow‐up revealed that both the intervention and the control groups exhibited clear reductions in lesion sizes. There was no significant added benefit in using collagen membranes alone in endodontic surgery (Parmar et al 2019…”

Section: Discussionmentioning

confidence: 99%

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Impact of different regenerative techniques and materials on the healing outcome of endodontic surgery: a systematic review and meta‐analysis

2020

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Background Regenerative techniques are increasingly applied in endodontic surgery, but different materials used in regenerative techniques may have varying impacts on wound healing. Objectives This study evaluated the effects of different regenerative techniques and materials on the outcome of endodontic surgery. Participants: patients with persistent periapical lesions, treated with root‐end surgery. Control: endodontic surgery without the use of regenerative techniques/materials. Intervention: endodontic surgery with the use of regenerative techniques/materials. Outcome: combined clinical and radiographic results. Methods PubMed, Web of Science, Embase, SinoMed and the CENTRAL Cochrane were searched up to 10th July 2020, followed by a manual search. Detailed eligibility criteria were applied. Cochrane’s risk‐of‐bias tool 2.0 was used to assess the risk of bias of the eligible studies. Meta‐analysis was conducted using RevMan software. Subgroup analyses were performed based on the regenerative materials used in endodontic surgery. Results Eleven eligible randomized controlled trials (RCTs) were included in the meta‐analysis: two had a low risk of overall bias, and nine had some concerns of overall bias. Generally, the use of regenerative techniques significantly improved the outcome of endodontic surgery (risk ratio [RR]: 0.42; 95% confidence interval [CI], 0.26–0.68; P < 0.001). On subgroup analysis, the use of expanded polytetrafluoroethylene (e‐PTFE) membranes alone had no added benefits (RR: 2.00; 95% CI, 0.22–18.33; P = 0.54). The application of collagen membranes or autologous platelet concentrates (APCs) alone was associated with a trend for better outcomes (RR: 0.51; 95% CI, 0.20–1.25; P = 0.14) (RR: 0.55; 95% CI, 0.18–1.71; P = 0.30). The combined use of collagen membranes and bovine‐derived hydroxyapatite significantly improved the outcome (RR: 0.35; 95% CI, 0.17–0.75; P = 0.007). Discussion This systematic review evaluated the effects of collagen membranes, e‐PTFE membranes, APCs and bone grafting materials, providing detailed information about the risks and benefits of using each regenerative technique/material or its combination in endodontic surgery. Conclusions Regenerative techniques improve periapical lesion healing after endodontic surgery. The combined use of collagen membranes and bovine‐derived hydroxyapatite may be beneficial as an adjunct to endodontic surgery. In contrast, the positive efficacy of e‐PTFE membranes or APCs alone remains doubtful.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Impact of different regenerative techniques and materials on the healing outcome of endodontic surgery: a systematic review and meta‐analysis

2020

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“…Large lesions take longer to heal completely or heal by scar tissue, in either condition, as long as the patient is asymptomatic the case should be followed up (Parmar et al . 2019). This was corroborated by a histopathological study of surgical retreatment re‐operations of cases assessed as non‐healed by CBCT.…”

Section: Discussionmentioning

confidence: 99%

Palatal root surgery of a maxillary molar using a piezosurgery transantral approach with simultaneous sinus lift grafting: a case report

et al. 2020

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Aim To report a case involving transantral palatal root piezoelectric surgery followed by a sinus floor augmentation procedure with the purpose of minimizing and managing complications associated with sinus lining perforations and optimizing bone regeneration at the site of the surgical defect. Summary An asymptomatic 28‐year‐old male patient with the diagnosis of chronic apical periodontitis on a previously root filled right maxillary first molar (FDI tooth 16) and second premolar (No. 15) was managed by transantral apical surgery. Cone‐beam computerized tomography (CBCT) revealed the position of the palatal root of the first molar within the maxillary sinus. The case highlights the management of the palatal root and the handling of a perforation of the Schneiderian membrane through a combination of piezosurgery and a sinus lift grafting procedure involving a second‐generation of platelet concentrates. No postoperative complications were observed. Sinus bone augmentation after a 26‐month recall period was confirmed by CBCT in the clinically asymptomatic teeth. Key learning points The selective bone tissue cutting and enhanced visibility obtained by piezoelectric surgery in comparison with current rotary techniques make this technology the preferred tool for apical surgery when the mucosal lining of the maxillary sinus could be compromised. The wound healing and physical properties of the platelet‐rich fibrin membranes in combination with an allograft material can be considered as sinus bone graft options when a transantral approach is performed on a palatal root of a maxillary molar. A preoperative tomographic examination is essential for apical surgery using a transantral approach with sinus bone augmentation, because of the information obtained from the axial and coronal views on the CBCT scan.

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“…For the final consideration of the study, 11 of the articles were considered for the meta-analysis. [ 8 14 15 16 17 18 19 20 21 22 23 ] Figure 1 describes the selection of the articles.…”

Section: R Esultsmentioning

confidence: 99%

Various Assisted Bone Regeneration in Apicectomy Defects Systematic Review and Meta Analysis

Sumangali

Tiwari

Kollipara

et al. 2021

Journal of Pharmacy and Bioallied Sciences

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Introduction: In the endodontic surgery, the common applications are the procedures that apply regenerative methods. There are various methods that help in the regeneration after the endodontic root end cutting or apicectomy. The outcome of the apicectomy depends on the procedure and the material. Hence in the present study, we intend to conduct the systemic review and meta-analysis of the various assisted bone regeneration in apicectomy defects. Materials and Methods: The study was conducted by the online search of the data that included the studies for the regenerative procedure in the endodontic surgery in patients with various periapical pathologies. The data search engines were Scopus, Web of Science, Google Scholar, and PubMed. The risk of the bias was calculated. The study participants were divided into case and control groups. Case group had undergone the regenerative surgery for the persistent periapical lesions, while the control group had not undergone the regenerative surgery for the persistent periapical l. The clinical and the radiograph outcomes were compared between the control and the case groups. Meta-analysis was done and the subgroups were evaluated. Results: From a total of 1561 articles, only 11 were finalized for the study to conduct the meta-analysis. The bias was noted for majority of the studies most of which were clinical trials. It was observed that the regenerative methods used in the endodontic surgery have significantly improved the outcome. The application of the expanded polytetrafluoroethylene only has no significant effect; however, application of the autologous platelet concentrates or collagen membranes only had good outcomes. The combination of the materials showed a significant outcome than when applied alone. Conclusions: From this meta-analysis, it is evident that regenerative procedures are beneficial in the endodontic apicectomy procedures. The materials used in these procedures will augment the outcome. A better prognosis is expected if the combination of the materials is used.

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2D and 3D radiographic outcome assessment of the effect of guided tissue regeneration using resorbable collagen membrane in the healing of through‐and‐through periapical lesions – a randomized controlled trial

Cited by 29 publications

References 21 publications

Impact of different regenerative techniques and materials on the healing outcome of endodontic surgery: a systematic review and meta‐analysis

Impact of different regenerative techniques and materials on the healing outcome of endodontic surgery: a systematic review and meta‐analysis

Palatal root surgery of a maxillary molar using a piezosurgery transantral approach with simultaneous sinus lift grafting: a case report

Various Assisted Bone Regeneration in Apicectomy Defects Systematic Review and Meta Analysis

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