Bone-regeneration After Apical Surgery Using Reabsorbable Membrane And Powder Bone

Apical surgery may be considered when conventional root canal re-treatment cannot be performed or has failed. It is a surgical procedure performed at the apex of dental pieces to resolve chronic problems that involve infectious processes or post-endodontic complications. This treatment not ever has the expecting success, many times due to the invagination of connective tissue into the prepared surgical window which obstructs bone modeling. Also, if bone damage is severe, the regeneration of this tissue could be unsatisfactory. Objectives: To assess perirradicular bone regeneration during 24 months post-apical surgery performed using a reabsorbable membrane and osteoinductor biomaterial. Methods: In human patients with apical pathology of dental pieces, treated endodontically, apical surgery was performed including the collocation of reabsorbable biologic fascia lata membrane (Biotar) between the flap of total wide and bone tissue. In the middle of them lyophilized human powder bone (Biotar) was collocated as osteoinductor with the objective to obtain an adequate recuperation of perirradicular bone tissue. Amoxicillin (500mg) as antibiotic and sodium phosphate of dexametasona (2 ml, EV) as anti-inflammatory were prescribed for 7 days, and ketorolac (10 mg, SL) as analgesic for 2 days. Clinical and radiographic control was performed for 24 months. Results: Three months after the surgery, pain, inflammation and discomfort were not evidenced. Twelve moths after the surgery radiographic images of periradicular bone clearly improved as compared to pre-surgical images. Significant less radio-lucid image was observed. Twenty four months after the surgery, the clinical symptoms disappeared and the radiographic images became normal, without fibrosis. Conclusion: The present results demonstrate that the utilization of human fascia lata membrane plus powder bone improves and accelerates bone regeneration after apical surgery and can be used in severe cases of alveolar bone loss. (Grants: UBACyT-O007 and UBACyT-20020090300051)