Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology
EndodontologyHistologic evaluation of the use of membrane, bone graft, and MTA in apical surgery
Section snippets
Material and Methods
Forty-eight mandibular roots of second and third premolars from 6 male adult mongrel dogs aged 2-3 years and weighing ∼25 kg were used. Procedures in this experiment were conducted according to the guidelines approved by the Research Committee of São Paulo State University, Brazil.
The animals were anesthetized with 2 mL of a mixture of xylazine (Rompum; Bayer do Brasil, São Paulo, Brazil) and ketamine hydrochloride (Ketalar; Park Davis-Aché Laboratórios Farmacêuticos, São Paulo, Brazil) in a
Results
Five specimens were excluded due to fracture or periodontal lesion. All remaining specimens in all groups exhibited new eosinophilic cementum recovering the cut dentin. The resected area exhibited resorption remodeling of the apical surface, but no active resorption was observed in the new cementum. No debris was found which could lead the treatment to failure. All groups had the filling material at the dentinal surface level. Brown and Brenn staining method did not exhibit microorganisms in
Discussion
The use of GTR in endodontic lesions has been described in several reports,18, 19, 20, 21, 22, 23 which generally resulted in clinical improvement. The present study evaluated the use of membranes, bone graft, and a combination of the two in apical surgery in which the apical sites were critical and the root-end cavities were filled with MTA.
In this study, MTA was chosen as the root-end filling material owing to the promotion of favorable tissue reactions, characterized by the absence of
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Cited by (22)
Periradicular regenerative surgery in a maxillary central incisor: 7-Year results including cone-beam computed tomography
2014, Journal of EndodonticsCitation Excerpt :MTA was used as the root-end filling material because of its superior properties in terms of lack of inflammation, tissue biocompatibility, osteogenesis, periodontal ligament regeneration, and cementogenesis (28, 30, 31). A study by Bernabé et al (32) showed that the use of membranes and bone graft materials isolated or associated in apical surgery did not alter the periapical healing process after root-end filling with MTA. Hard tissue formation apically, interproximally, and partly facially was confirmed by CBCT imaging 7 years postoperatively.
Effects of bone graft materials on the microhardness of mineral trioxide aggregate
2012, Journal of EndodonticsCitation Excerpt :There are reported benefits of grafting in the treatment of apicomarginal defects (7), large lesions (5), and lesions that violate both buccal and lingual cortical plates (6). However, a study by Bernabé et al (29) showed that placement of graft material in the crypt has no effect on the histologic appearance of osseous tissue approximating retrofills consisting of gray MTA in 6 dogs. It has also been reported that placement of graft material in routine apicoectomies associated with smaller lesions carries no benefit (2).
Effect of suided tissue regeneration on newly formed Bone and cementum in periapical tissue healing after endodontic surgery: An in vivo study in the cat
2012, Journal of EndodonticsCitation Excerpt :However, in large periapical lesions, wound healing requires recruitment and the differentiation of progenitor cells/stem cells into osteoblasts, cementoblasts, and PDL cells (37). In a human study on 25 patients, placing a synthetic double-layered absorbable membrane over the bony opening created during endodontic surgery had no beneficial effect on the rate of healing (18), which has been supported by others (13, 14). In another study (9), periradicular surgery was performed on the maxillary molars of 12 cats using either resorbable membrane or human osteogenic protein-1 in a collagen carrier.
The use of regenerative techniques in apical surgery: A literature review
2011, Saudi Dental JournalCitation Excerpt :Weaknesses of study: short study period; defect size not mentioned; no information about root-end filling material.) Bernabé et al. (2010) evaluated periapical healing after the use of guided tissue regeneration (membrane, bone graft or combinations) in apical surgery. Apical lesions were induced in mandibular premolars of dogs, and 3 months later, root-canal treatment and apical surgery were carried out.
The impact of bone grafting with/without barrier membrane placement on the outcome of apical surgery: A systematic review and meta-analysis
2024, International Endodontic Journal