The use of calcium sulphate in the surgical treatment of a 'through and through' periradicular lesion.
OBJECTIVE
This randomized, controlled, clinical study was designed to evaluate the adjunctive effect of calcium sulphate grafts on the surgical treatment of through and through periradicular lesions.


METHODS
Twenty patients each with one tooth showing evidence radiologically of a periradicular lesion wider than 10 mm, with lack of both buccal and lingual cortical bony plates and an indication for surgery were selected for the study. Ten teeth were treated with apicectomy, root-end filling and grafting of the bone defect with calcium sulphate prior to suturing (test group). The other 10 teeth received the same surgical therapy but no grafting with calcium sulphate (control group). The outcome of the healing process was evaluated at 6 and 12 months radiographically following the criteria reported by Rud and Andreasen.


RESULTS
At the six- and 12-month evaluation the test group had seven teeth with complete healing and two with incomplete healing, whilst the control group showed three teeth with complete healing, five with incomplete healing and one with unsatisfactory healing. One tooth in each group had to be extracted because of a vertical fracture that occurred during the follow-up period.


CONCLUSIONS
The results of the study demonstrate that the addition of calcium sulphate as a bone graft during the conventional surgical treatment of through and through lesions improves the clinical outcome. Histological analysis is desirable to investigate the quality of tissues formed using the two surgical procedures.
University of Pennsylvania, Philadelphia, Pennsylvania, USA.
G
G
Pecora
D
D
De Leonardis
N
N
Ibrahim
M
M
Bovi
R
R
Cornelini
D000328:Adult; D016301:Alveolar Bone Loss / Q000601:surgery*; D001047:Apicoectomy; D018786:Bone Substitutes / Q000627:therapeutic use*; D002133:Calcium Sulfate / Q000627:therapeutic use*; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D010483:Periapical Diseases / Q000601:surgery*; D011183:Postoperative Complications; D012184:Retrograde Obturation; D013530:Surgical Wound Infection / Q000209:etiology; D014082:Tooth Fractures / Q000209:etiology; D016896:Treatment Outcome; D014945:Wound Healing
D018786:Bone Substitutes; D002133:Calcium Sulfate