Restor Dent Endod.  2022 May;47(2):e17. 10.5395/rde.2022.47.e17.

Leukocyte platelet-rich fibrin in endodontic microsurgery: a report of 2 cases

• Pires MD
• Martins JNR
• Baruwa AO
• Pereira B
• Ginjeira A

• KMID: 2548121
• DOI: http://doi.org/10.5395/rde.2022.47.e17

Abstract

Endodontic microsurgery is a predictable treatment option when orthograde treatment or retreatment is unsuccessful or unfeasible. However, when there is a gross compromise of periapical bone, achievement of bone regeneration after the surgical procedure may be hampered. In such cases, the application of guided tissue regeneration principles, with adjunctive use of leukocyte platelet-rich fibrin to fill the bone defect as a bone substitute and as a membrane to cover the site, provides a cost-effective solution with the benefits of accelerated physiological healing and reduced post-surgical pain and discomfort. This case report presents 2 cases of endodontic microsurgery of the upper lateral incisors with loss of buccal cortical plate, where platelet-rich fibrin was successfully applied.

Keyword

Endodontics; Guided tissue regeneration; Microsurgery; Leukocyte-platelet-rich fibrin

Figure

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  Figure 1 Chronological documentation of case 1: (A) initial periapical radiograph of tooth #22; (B) working length confirmation; (C) periapical radiograph showing the final root canal treatment; (D, E, F) axial, sagittal, and coronal views of cone-beam computed tomography prior to endodontic microsurgery; (G) mucoperiosteal flap; (H) apicoectomy, retrograde preparations, and obturation with MTA; (I) previously prepared leukocyte platelet-rich fibrin membranes used to fill and cover the surgical bone defect; (J) repositioned flap; (K) post-surgical periapical radiograph; (L) radiograph from a 6-month follow-up visit; (M) radiograph from a 12-month follow-up after endodontic microsurgery.

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  Figure 2 Chronological documentation of case 2: (A, B, C, D) Axial, sagittal, and coronal views of cone-beam computed tomography before root canal treatment; (E) initial periapical radiograph of tooth #22; (F) cleaned root canal after irrigation; (G) working length confirmation; (H) periapical radiograph showing the final root canal treatment; (I) mucoperiosteal flap; (J) apicoectomy, retrograde preparations, and obturation with mineral trioxide aggregate; (K) leukocyte platelet-rich fibrin membranes filling the bone defect; (L) repositioning of the surgical flap; (M) radiograph from a 2-month follow-up; (N) radiograph from a 4-month follow-up; (O) radiograph from a 6-month follow-up; (P) and radiograph from a 12-month follow-up after endodontic microsurgery.

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