[Guided-tissue regeneration in endodontic surgery].
OBJECTIVE
Endodontic surgery has for aim to treat bone lesions due to dental-canal infections. The authors investigated the success rate of guided-tissue regeneration (GTR) in endodontic surgery for large periapical lesions.


METHODS
Both bone defects with eroded lingual/palatal and buccal cortex (two-wall defect: transosseous) and lesions with noneroded lingual/palatal cortex (four-wall defect) were assessed. All lesions had a diameter of least 10mm. A total of 73 teeth in 55 patients were included according to specific selection criteria. Full mucoperiosteal tissue flap were used. A straight fissure bur in a hand-piece was positioned apically and 2.5 to 3mm of the root-end were shaved away. Root-end cavities, 2.5 to 3mm deep, were prepared with ultrasonic tips. Root-ends were sealed using Super EBA. The choice of using or not GTR associated with deproteinized bovine bone for each patient wax made by a computer-generated randomized table. For cases allocated to the GTR group, the defect was filled with anorganic bovine-bone mineral and then covered with a resorbable collagen membrane. The outcome was assessed by clinical and radiographic evaluation at one-year follow-up.


RESULTS
Sixty-nine teeth were evaluated at one year follow-up. Twenty-six cases were transosseous lesions. At the one-year follow-up, 56 teeth had successfully healed (81.2%), healing was uncertain for 10 teeth and three were classified as failure. The cases classified as uncertain healing were scheduled for another follow-up three years later.


CONCLUSIONS
According to published data, GTR as a complement of periapical surgery is not necessary for four-wall defects. However, it may be an indication for transosseous lesions.
Service d'odontologie, hôpital Galeazzi, université de Milan, Milan, Italie.
S
S
Taschieri
T
T
Testori
F
F
Azzola
M
M
Del Fabbro
P
P
Valentini
D020341:Absorbable Implants; D000328:Adult; D016301:Alveolar Bone Loss / Q000601:surgery; D001047:Apicoectomy / Q000379:methods; D001861:Bone Regeneration / Q000502:physiology; D018786:Bone Substitutes / Q000627:therapeutic use; D003094:Collagen; D017220:Dentin-Bonding Agents / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D016557:Guided Tissue Regeneration, Periodontal / Q000379:methods*; D006801:Humans; D008297:Male; D008567:Membranes, Artificial; D008903:Minerals / Q000627:therapeutic use; D010483:Periapical Diseases / Q000601:surgery*; D012184:Retrograde Obturation / Q000379:methods; D012387:Root Canal Filling Materials / Q000627:therapeutic use; D018915:Root Canal Preparation / Q000379:methods; D012390:Root Canal Therapy / Q000379:methods*; D013524:Surgical Flaps; D016896:Treatment Outcome; D014464:Ultrasonic Therapy / Q000379:methods; D014945:Wound Healing / Q000502:physiology
C106416:Bio-Gide; C077540:Bio-Oss; D018786:Bone Substitutes; D017220:Dentin-Bonding Agents; D008567:Membranes, Artificial; D008903:Minerals; D012387:Root Canal Filling Materials; C084074:Super EBA; D003094:Collagen