Premium
Use of Guided Tissue Regeneration in the Treatment of a Severe Endodontic–Periodontic Lesion: A 15‐Year Follow‐Up Case Report
Author(s) -
Santana Ronaldo B.,
Mattos Santana Carolina M.
Publication year - 2013
Publication title -
clinical advances in periodontics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.182
H-Index - 2
eISSN - 2163-0097
pISSN - 2573-8046
DOI - 10.1902/cap.2012.110098
Subject(s) - medicine , periodontium , lesion , dentistry , bleeding on probing , endodontic therapy , surgery , periodontitis , root canal
Introduction: Treatment of combined endodontic–periodontic lesions remains a considerable challenge in clinical practice. The degree of success in the management of these lesions is related to the efficacy of both periodontal and endodontic treatments and is influenced by specific anatomic characteristics of the lesion. This report presents the long‐term clinical outcomes of a severe endodontic–periodontic lesion treated by guided tissue regeneration (GTR) and documented over a 15‐year period. Case Presentation: A non‐smoking, 42‐year‐old female presented with a combined endodontic–periodontic lesion consisting of a large through‐and‐through apical lesion communicating with the marginal periodontium as a result of the complete loss of the facial bone plate. Treatment consisted of GTR and grafting with absorbable hydroxyapatite. The clinical variables evaluated were plaque, bleeding on probing (BOP), gingival recession, probing depth (PD), and clinical attachment level (CAL). Reevaluation was performed 1 year and 15 years after the surgical procedure. Healing was uneventful. Measurements revealed that PD was reduced by 17 mm, a 16‐mm CAL gain was recorded, and no BOP was detected at any tooth aspect. CAL gains were maintained up to the 15‐year recall. Radiographic evaluation demonstrated a complete resolution of the bony lesion at both 1 year and 15 years after surgery. Conclusion: Severe combined endodontic–periodontic lesions can be successfully treated via regenerative techniques, and the resultant bone and CAL gains are preserved for several years after the active treatment.