title: Periradicular regenerative surgery in a maxillary central incisor: 7-year results including cone-beam computed tomography.
abstract: BACKGROUND
  A case of a symptomatic maxillary central incisor that underwent periradicular regenerative surgery with a successful long-term clinical and radiographic outcome is presented.
  
  
  METHODS
  A 52-year old woman was referred to the Endodontology Clinic, UCL Eastman Dental Institute and Hospital, London, UK, in 2004 for swelling and discoloration of the maxillary right central incisor. There was a history of trauma 21 years previously. The tooth was endodontically treated 5 years before the referral. At presentation, there was diffuse facial swelling/erythema and a periodontal probing depth of 11 mm on the midfacial surface with bleeding on probing and purulent exudate. Endodontic retreatment was completed along with subgingival debridement. Reassessment at 6 weeks showed persistent purulent exudate and a probing depth up to 13 mm facially. Periradicular surgery was performed for the purposes of surgical exploration, apical resection and root-end filling with mineral trioxide aggregate, and guided tissue regeneration using a bone xenograft and collagen membrane. Histopathology confirmed the presence of a radicular cyst.
  
  
  RESULTS
  Clinical and radiographic evaluation, including cone-beam computed tomographic imaging, at 7 years postoperatively showed a probing depth up to 3 mm and hard tissue formation apically, interproximally, and partly facially on the root surface.
  
  
  CONCLUSIONS
  In this case of a combined endodontic-periodontic lesion in a maxillary central incisor, regenerative periradicular surgery led to the resolution of the defect, significant attachment gain, and a stable clinical and radiographic outcome after 7 years of follow-up.
authors.affiliation: Restorative Division, UCL Eastman Dental Institute and Hospital, London, United Kingdom. Electronic address: stella.k@hotmail.co.uk.
authors.forename: Stella
authors.initials: S
authors.lastname: Kourkouta
authors.affiliation: Unit of Endondontology, UCL Eastman Dental Institute and Hospital, London, United Kingdom.
authors.forename: Graham C
authors.initials: GC
authors.lastname: Bailey
mesh_terms: D017607:Aluminum Compounds / Q000627:therapeutic use; D001047:Apicoectomy / Q000379:methods*; D016025:Bone Transplantation / Q000379:methods; D017610:Calcium Compounds / Q000627:therapeutic use; D003094:Collagen; D054893:Cone-Beam Computed Tomography / Q000379:methods*; D003646:Debridement / Q000379:methods; D004338:Drug Combinations; D005260:Female; D005500:Follow-Up Studies; D016557:Guided Tissue Regeneration, Periodontal / Q000379:methods*; D064593:Heterografts / Q000637:transplantation; D006801:Humans; D007180:Incisor / Q000000981:diagnostic imaging / Q000601:surgery*; D008437:Maxilla; D008567:Membranes, Artificial; D008875:Middle Aged; D010087:Oxides / Q000627:therapeutic use; D010482:Periapical Abscess / Q000601:surgery; D017622:Periodontal Attachment Loss / Q000601:surgery; D010514:Periodontal Pocket / Q000601:surgery; D011842:Radicular Cyst / Q000601:surgery; D019233:Retreatment; D012184:Retrograde Obturation / Q000379:methods*; D012387:Root Canal Filling Materials / Q000627:therapeutic use; D017640:Silicates / Q000627:therapeutic use; D019553:Tooth, Nonvital / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome
chemical_list: D017607:Aluminum Compounds; D017610:Calcium Compounds; D004338:Drug Combinations; D008567:Membranes, Artificial; D010087:Oxides; D012387:Root Canal Filling Materials; D017640:Silicates; C086631:mineral trioxide aggregate; D003094:Collagen
keywords: Apical pathology; apical periodontitis; apical surgery; apicoectomy; combined endodontic-periodontic lesion; cone-beam computed tomographic imaging; guided tissue regeneration; periradicular surgery; radicular cyst; regenerative surgery