Surgical approach to endo-periodontal lesion using xenogeneic biomaterial: a 12-month follow-up case report
DOI:
https://doi.org/10.69849/mahc8s12Keywords:
Endo-periodontal lesions, Bone defects, Synthetic bone substitutes, Case reportAbstract
Introduction: Endo-periodontal lesions (EPL) represent significant clinical challenges due to the pathological communication between pulpal and periodontal tissues, often leading to a guarded prognosis. Case Report: A 50-year-old female patient, a smoker, sought a second opinion after being advised to undergo extraction of tooth 47. Cone-beam computed tomography (CBCT) revealed an endo-perio lesion with severe bone loss in the distal root and furcation area. The treatment plan prioritized tooth preservation, starting with endodontic therapy to eliminate the intracanal infectious focus. Subsequently, a surgical approach was performed using an envelope flap for root and site decontamination under direct visualization, employing Gracey curettes and chemical conditioning with citric acid (10%, pH 1.0 for 3 minutes). After rigorous curettage and confirmation of the absence of infected tissues, the bone defect was filled with lyophilized bovine bone graft (Bonefill Porous, medium granulation). Closure was achieved with simple interrupted sutures (5.0 nylon). Results: Clinical and radiographic follow-up at 12 months demonstrated satisfactory evolution of graft osseointegration, bone neoformation, and maintenance of periodontal health. Conclusion: The association between endodontic treatment and filling with xenogeneic biomaterial proved effective in resolving the EPL, allowing for the functional and biological preservation of a tooth previously condemned to extraction.
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