Healing assessment of osseous defects of periapical lesions with use of freeze dried bone allograft

Abstract

Objectives The aim of this study was to save endodontically failed teeth with periapical pathosis by surgery. Elimination of the periapical pathology and to evaluate the clinical and radiological efficiency of freeze dried bone allograft in bony defects. Materials and methods Ten patients were included in this study with established periapical pathology with the need for periapical surgery after failed endodontic therapy. Surgery was decided after the cessation of acute symptoms. Patients on regular medications for known medical complications were excluded from the study. A full thickness flap or modified Leubke-ochsecnbein was raised depending upon the size and location of the lesion. Thorough periapical curettage was performed to remove the pathological tissue surrounding the apices and the root of the tooth. The graft material was mixed with patient's venous blood drawn earlier from a peripheral vein to make it more cohesive. The graft material mixed with blood was then carefully packed with light pressure into the defect. The flap was replaced. All the patients received broad spectrum antibiotics one day before and five days after surgery. The cases were followed up with clinical and radiological examination and were recalled at intervals of 1 month, 3 months and 5 months postoperatively to assess the condition of the periapical area. Results In all the ten cases at the end of 1st month postoperatively a well defined border separating the host bone from the graft material indicating simultaneous resorption of the graft. This resorption continued at 3 months follow up indicating continued graft resorption and also increasing radioopacity, haziness indicating bone regeneration. Eight of the ten patients could be evaluated at the end of fifth month and radiographs showed increase in radioopacity and reduction in size of periapical radiolucency as well as normal trabecular pattern of the bone. Conclusion The results demonstrate successful use of FDBA in the treatment of osseous defects of periapical lesions associated with failed endodontically treated teeth.

The impact of bone grafting with/without barrier membrane placement on the outcome of apical surgery: A systematic review and meta‐analysis

“…Four were animal studies (Bernabe et al., 2010; Douthitt et al., 2001; Pecora et al., 1997; Yoshikawa et al., 2002). Two studies had a follow‐up of less than 1 year (Lingaraj et al., 2009; Sreedevi et al., 2011). Two studies were retrospective (Lui et al., 2014; Taschieri et al., 2011).…”

Acemannan induces rapid early osseous defect healing after apical surgery: A 12-month follow-up of a randomized controlled trial

“… 5 , 6 Conversely, other studies have shown that regenerative materials enhance bone healing, indicating that the addition of bone grafts is beneficial to clinical outcomes. 7 , 8 , 9 , 10 Because of the disparate methodologies and results in the various studies to date, there is still no consensus as to the benefits of regenerative materials on bone defect healing post-surgery.…”

Efficacy of decalcified freeze-dried bone allograft in the regeneration of small osseous defect: A comparative study

“…Carious lesions leading to bacterial invasion of pulp tissue, leading to necrosis of the pulp are the common causes of periapical pathology. [ 1 ] Bacteria in the periapical region lead to periapical abscess, granuloma, or periapical cyst. Destruction in the periapical region leads to destruction of bone known as an “osseous defect.”[ 1 ]…”